Counseling Across Cultures: Essential Wisdom for Understanding Diverse Populations

Counseling Across Cultures
Seventh Edition
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Counseling Across Cultures
Seventh Edition
Edited by
Paul B. Pedersen
Syracuse University (Emeritus); University of Hawaii
(Visiting); Maastricht
School of Management
Walter J. Lonner
Western Washington University (Emeritus)
Juris G. Draguns
Pennsylvania State University (Emeritus)
Joseph E. Trimble

Western Washington University
María R. Scharrón-del Río
Brooklyn College City University of New York
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For INFORMATION:
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Contents
Acknowledgments
Foreword
Dedication
Introduction: Learning From Our “Culture Teachers”
PART I. ESSENTIAL COMPONENTS OF CROSS-CULTURAL
COUNSELING
1. Toward Effectiveness Through Empathy
2. Counseling Encounters in Multicultural Contexts: An
Introduction
3. Assessment of Persons in Cross-Cultural Counseling
4. Multicultural Counseling Foundations: A Synthesis of
Research Findings on Selected Topics

PART II. ETHNOCULTURAL CONTEXTS AND CROSS-
CULTURAL COUNSELING
5. Counseling North American Indigenous Peoples
6. Counseling Asian Americans: Client and Therapist Variables
7. Counseling Persons of Black African Ancestry
8. Counseling the Latino/a From Guiding Theory to Practice:
¡Adelante!
9. Counseling Arab and Muslim Clients
PART III. COUNSELING ISSUES IN BROADLY DEFINED
CULTURAL CATEGORIES
10. Gender, Sexism, Heterosexism, and Privilege Across
Cultures
11. Counseling the Marginalized
12. Counseling in Schools: Issues and Practice
13. Reflective Clinical Practice With People of Marginalized
Sexual Identities
PART IV. COUNSELING INDIVIDUALS IN TRANSITIONAL,
TRAUMATIC, OR
EMERGENT SITUATIONS
14. Counseling International Students in the Context of Cross-
Cultural Transitions
15. Counseling Immigrants and Refugees
16. Counseling Survivors of Disaster
17. Counseling in the Context of Poverty
18. The Ecology of Acculturation: Implications for Counseling
Across Cultures
PART V. PROFESSIONAL COUNSELING IN A SELECTION
OF CULTURE-MEDIATED
HUMAN CONDITIONS AND CIRCUMSTANCES
19. Health Psychology and Cultural Competence
20. Well-Being and Health

21. Family Counseling and Therapy With Diverse Ethnocultural
Groups
22. Religion, Spirituality, and Culture-Oriented Counseling
23. Drug and Alcohol Abuse and Health Promotion in Cross-
Cultural Counseling
24. Group Dynamics in a Multicultural World
Index
About the Editors
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About the Contributors
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Elder Wisdom
An elder Lakota was teaching his grandchildren about life. He
said to them, “A fight is going on inside me... it is a
terrible fight and it is between two wolves.
One wolf represents fear, anger, envy, sorrow, regret, greed,
arrogance, self-pity, guilt, resentment, inferiority, lies,
false pride, superiority, and ego.
The other stands for joy, peace, love, hope, sharing, serenity,
humility, kindness, benevolence, friendship, empathy,

generosity, truth, compassion, and faith.
This same fight is going on inside you, and inside every other
person, too.”
The grandchildren thought about it for a minute, and then one
child asked her grandfather, “Which wolf will win?”
The Elder replied simply, “The one you feed.”
The Western conception of the person as a bounded, unique,
more or less integrated motivational and cognitive
universe, a dynamic center of awareness, emotion, judgment,
and action, organized into a distinctive whole and set
contrastively—both against other such wholes and against social
and natural background—is however incorrigible it
may seem to us, a rather peculiar idea within the context of the
world’s cultures. (p. 34)
Geertz, C. (1973). The interpretation of cultures: Selected
essays. New York: Basic Books.
The first peace, which is the most important, is that which
comes within the souls of men when they realize their
relationship, their oneness, with the universe and all its Powers,
and when they realize that at the center of the
universe dwells Wakan-Tanka, and that this center is
everywhere,it is within each of us. This is the real Peace, and
the others are but reflections of this.
The second peace is that which is made between two
individuals, and the third is that which is made between two
nations. But above all you should understand that there can
never be peace between nations until there is first known
that true peace which... is within the souls of men. (p. 198)

Black Elk, in Neihardt, J. G. (1961). Black Elk speaks: Being
the life story of the holy man of the Oglala Sioux.
Lincoln: University of Nebraska Press.
Conscientization does not consist, therefore, of a simple change
of mind about reality, of a change in individual
subjectivity that leaves intact the objective context;
conscientization supposes a change in people in the process of
changing their relationship with the environment, and above all,
with others.
True knowledge is essentially bound with transformative social
action and involves a change in the relationship
between human beings.
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Martín-Baró, I., & Blanco Abarca, A. (1998). Psicología de la
liberación. Madrid: Editorial Trotta.
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Acknowledgments
Nearly every academic book ever published has acknowledged
individuals who in some way played important
roles in the book’s development. In this book we depart from
the usual custom and acknowledge those who,
on one hand, were important in organizing, editing, and
producing the book, as well as those who, on the
other hand, played important roles in the lives of the five
coeditors. The former can be considered general

acknowledgments that we all share. The latter are necessarily
different for each of us. Thus we have agreed to
contribute individually.
In the general category we want to thank SAGE Publications for
the confidence it has shown in us
throughout the years. The two key SAGE people with whom we
have worked are Kassie Graves, who has
been part of this effort for many years, and her assistant, Carrie
Baarnes. Although a relative newcomer to
SAGE, Carrie was a big help in the latter stages. We were
flattered that Claudia Hoffman, SAGE’s director
of U.S. book production, pointedly selected Counseling Across
Cultures as a book she wanted to usher through
its final copyediting and production stages. In characteristic
good judgment, Claudia chose Judy Selhorst to be
copy editor for the book. It is remarkable how careful and
efficient Judy was during the latter part of the
process, when it is so important to be complete and precise.
Candace Harman and her crew in the graphics
department did an excellent job with the cover. Further north,
on the campus of Western Washington
University, is Genavee Brown. A graduate student in the
Department of Psychology and a most promising
young scholar, Genavee was “the organizer” in crucial stages.
When the book is published, the first copy will
go to Paul Pedersen and the second will go to Genavee.
On the personal side, we offer the following highly
individualized acknowledgments:
Paul B. Pedersen. I would like to acknowledge and to dedicate
my role in the preparation of this book to
Anthony J. “Tony” Marsella, professor emeritus of the
University of Hawaii. Tony was my prime teacher at so
many different levels. He was as comfortable in the village

council of a Borneo community as he was, for
example, during a World Health Organization committee
meeting many years ago, or as he was in his lectures
throughout his illustrious career. The classes he taught would
frequently end with standing ovations by his
students. He originated the awareness, knowledge, and skill
model, which became the basis of the measures
for competence within the field of multicultural counseling.
Many other examples of his influence come to
mind. Most important, he has in recent years become a first-
class friend and co-traveler in life’s journey. In
the metaphor of family, Tony has fathered many children among
his students, his colleagues, and his other
brothers and sisters. For all that you have given, Tony, I send
you my thanks.
Walter J. Lonner. Above all else I want to thank my immediate
family, consisting of many people, both living
and dead. Among the living are my everything-and-then-some
wife, Marilyn, and our three great children
(Jay, Alyssa, and Andrea), each of whom has two daughters
with terrific spouses. The world had better watch
out for those six little dynamos. By name and current age they
are Sika (14) and Brenna (11) Lonner, Sophia
(11) and Alena (8) Naviaux, and Nina (7) and Sage (4)
Howards. I was blessed with great parents and two
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brothers: Terry, the youngest of us, who is a beacon of honor
and dependability and a jack-of-all-trades; and
George, the oldest. We grew up in beautiful and generous
western Montana. George died October 8, 2012,

about midway through the work on this book. George was the
family’s Don Quixote, dreaming big things and
imagining the impossible. It is he, not I, who should have been
a university professor, for he would have
dazzled thousands of students with his talent of mixing fact
with fantasy. The encouragement and praise that
Terry and George and the rest of my family piled upon me,
through thick and thin, has always kept me going.
I also want to acknowledge the multidimensi onal influence that
an international network of scholars has had
on my 50-plus years of trying to understand the nature of
culture’s influence on everything we say, think, and
do. Part of this network consists of the many talented people,
including the current slate of coeditors, who
have contributed to one or more of the seven editions of
Counseling Across Cultures.
Juris G. Draguns. Throughout the seven editions of Counseling
Across Cultures, I have enjoyed marvelous
support, encouragement, and understanding from my wife,
Marie. We have shared 52 wonderful years, and
Marie’s love and empathy have helped me overcome whatever
obstacles have stood in my way, sometimes
tangible, more often subjective. As I thought about, wrote, and
edited Counseling Across Cultures, I would
temporally disappear into the book, and Marie was always there
to welcome me when I reemerged from its
pages. My two children, Julie and George, were young when
Counseling Across Cultures first appeared. They
grew up as the book evolved through its several
transformations, and the two processes intertwined. What has
remained constant is our mutual love and my vicarious
enjoyment of and pride over Julie’s and George’s
families, careers, and achievements. Thinking back on my early
years, I gratefully remember my parents,
especially my mother, who instilled in me a curiosity and love

of learning and protected me from the
dangerous world outside our home. It is thanks to her that I
survived and was able to work toward the
realization of my version of the American Dream. And in the
course of the ensuing multiple transitions I
benefited from a host of culture teachers who helped me become
more empathetic and perhaps more helpful
across cultural barriers. They are too numerous to mention, but
my sincerest thanks go to them all.
Joseph E. Trimble. I owe Paul Pedersen a special measure of
personal gratitude and appreciation. In August
1972 Paul met with me and my wife, Molly, at a lanai in
Honolulu. Over a late-morning breakfast he vividly
described his new triad theory of counseling training to
underscore his strong growing interest in culture and
psychological counseling. It was a memorable occasion for the
three of us. A few years later, Paul invited me
to give a symposium paper on counseling American Indians and
later publish a chapter in the first edition of
Counseling Across Cultures. Molly was extremely helpful when
I wrote that first chapter and continues to be
insightful and helpful in almost all of my writing activities. She
has a keen eye for detail and a spirited mind
for novel concepts and ideas. Throughout the course of each of
the Counseling Across Cultures editions our
three lovely and talented daughters, Genevieve, Lee Erin, and
Casey Ann, have been with me when each
edition arrived home for their review and comment, and it has
always been a proud moment for me when they
read their names in the acknowledgments and commented on it.
Also, I am deeply grateful for all of the
people who have provided me with guidance, advice, and
collaboration on the contents of the various chapters
put together for the seven editions. Thank you especially to
Candace Fleming, Fred Beauvais, Pamela Jumper

Thurman, and John Gonzales.
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María R. Scharrón-del Río. I am very grateful for the love,
guidance, and support of mi familia. My mother,
Rosarito, and my sister Marilia housed and fed me in Puerto
Rico as I was finishing the final editing process
for this book. My sister Marichi also assisted me with her
commentary during this time, and my father,
Rafael, accompanied me on a couple of hour-long mental health
escapades to the ocean. I am also grateful to
my partner, Yvonne, for her love, support, and understanding,
and for providing a home for me in Germany
during part of my sabbatical. Many thanks also to my chosen
family in New York City—Cody, Mara, Barb,
Wayne, Paul, and Flo—who helped in too many ways to count. I
owe a special thanks to Joseph Trimble and
Guillermo Bernal, who have been outstanding mentors and
friends since I was an undergraduate student in
the Career Opportunities in Research (NIMH-COR) program at
the University of Puerto Rico. I also want
to thank Eliza Ada Dragowski for her exceptional work and
support in the completion of this book. Finally,
my thanks to the wonderful group of people who provided
additional guidance on the content of various
chapters of the book: Priscilla Dass-Brailsford, Stuart Chen-
Hayes, Hollyce Giles, Vic Muñoz, Delida
Sánchez, and Avi Skolnik.
Paul B. Pedersen
Walter J. Lonner

Juris G. Draguns
Joseph E. Trimble
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Foreword
During a lifetime of more than four score and four years, I have
seen culture change before my eyes like a fast-
moving kaleidoscope. Old ways of being are replaced rapidly by
new ones. Each generation upgrades its
relationships with the various environments that affect its
existence. As I developed and acquired more
information about my time-and-space world, I understood the
complexity of culture. In high school, I heard it
discussed in connection with geography. My teachers talked
about how the natural environments in which
people live necessarily influence their ways of life. Their
environments determine the kinds of homes they
build to protect themselves from outside elements. Since
climates vary from one time zone to another, it is
tenable to conclude that the structures in which people live and
work also differ from one part of the world to
another.
In undergraduate school, I learned other things about culture.
People in various groups often dress differently
from one another and may speak languages other than English.
They often observe religious practices
different from the ones I knew. From the social science classes I
took, I acquired a general understanding of

culture. After graduating from college, I spent two years in
Europe. There I saw up close what my professors
had meant about people being different from one part of the
world to another. I kept journals on places I
visited and people I met that confirmed the content of my
professors’ lectures. Notable among my experiences
was the day I encountered Jean-Paul Sartre and his companion
Simone de Beauvoir in a small Parisian café
where they were reading some of their works. When I entered
graduate school at Indiana University,
understanding culture was my passion. I read as much as I could
about it; I took as many sociology courses as I
could work into my academic program. I learned that there were
more than a hundred definitions of culture
and that cultural theorists used a variety of concepts to
highlight ideas that they deemed uniquely theirs. I
learned that culture is not only material but also immaterial.
That is, there are objects in our environment that
determine the nature of our existence. There are also many
things we cannot see. For example, we have values
and attitudes about everybody and everything. People interact
with their surroundings. The individual’s
behavior is influenced by that of others. Culture is learned. It is
experienced and internalized. This
internalization is often referred to as personality. It is conscious
and unconscious, affective and cognitive,
perceptible and imperceptible, and much more.
When I became a practicing psychologist and counselor
educator, I felt the need to understand the cultures of
my clients, because I soon became aware that their problems
were usually related to the cultural contexts in
which they grew up and resided. By the 1960s, the civil rights
movement in the United States was going full
blast. Integration was becoming a reality for African Americans
who had previously lived in an apartheid-like

society. They had always lived in segregated communities and
attended segregated schools. After the changes
of the 1960s, African Americans began showing up in formerly
all-White classrooms and in the offices of
school counselors. The American Personnel and Guidance
Association (now called the American Counseling
Association, or ACA), officially organized in 1952, soon found
itself in the midst of the turmoil of a
dramatically changing society. Throughout the country, White
counselors were expected to help Black clients;
Black counselors were expected to help White clients. It was
out of the new clienteles and the different
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cultures they represented that a new interest area emerged in the
counseling profession. Paul Pedersen was
among the first educators to take the lead in helping counselors
and psychologists to meet more effectively the
needs of clients who came to be referred to as culturally
different. As I got to know Paul, I recognized that he
was visionary and just the right person to convene a panel of
counselors, counselor educators, and
psychologists to discuss cross-cultural counseling at the 1973
convention of the American Psychological
Association in Montreal. Out of the panel presentations came
the first edition of Counseling Across Cultures,
published in 1976. Becoming a classic in cross-cultural
counseling, it has contributed significantly to what is
now the fastest-growing movement in counseling. I am proud to
have been one of the participants on the
APA Montreal panel and a chapter contributor to the first
edition of the book.

After the Montreal panel presentation, I conceptualized a model
of culture designed to help counselors meet
the needs of their culturally challenging clients. I argue that
most human beings are molded by five concentric
cultures: (1) universal, (2) ecological, (3) national, (4) regional,
and (5) racio-ethnic. The human being is at
the core of these cultures, which are neither separate nor equal.
The first and most external layer is the
universal culture, or the way of life that is determined by the
physiology of the human species. People are
conceived in a given way, they consume nourishment to live,
they grow into adulthood, they contribute to the
group, and they grow old and die. These and other ways of life
are invariable dimensions of human existence.
During the course of the social development of the species,
people learn to play a variety of roles essential for
survival. These are internalized and transmitted from one
generation to another. It seems important that
counselors recognize themselves and their clients as members of
this culture that is common to all humanity.
The recognition helps counselors to identify with and assist all
clients, regardless of their cultural and
socioeconomic heritage.
Human existence is also shaped by the ecosystem, which is the
lifeline for everybody. Climatic conditions,
indigenous vegetation, animal life, seasonal changes, and other
factors determine how people interact with
nature and themselves. People who use dogsleds to go to the
grocery store experience life differently from
those who need only to gather foodstuffs from the trees and
plants in their backyards. Inhabitants of Arabian
deserts wear loose body coverings and headgear to protect
themselves from the dangerously hot rays of the sun
and from unexpected sandstorms. The way of life that people

develop in order to survive in a specific
geographical area of the world may be called the ecological
culture, the second layer of culture.
The third environment that molds human beings is the national
culture. It is reasonable to conceptualize a
national culture for several reasons. Most people are born into
particular nations. In general, each country has
a national language, basic institutions, and a form of
government, and the residents of the country have a way
of seeing the rest of the world and particular values and
attitudes about themselves and their fellows.
Individuals born within the confines of a country’s borders are
usually socialized to adjust to the rules and
regulations of that country. They learn to fit into the prevailing
way of life. People first start learning to fit
into the national social order in the home, and they continue
their socialization in school and other settings.
Although a country may contain several national subcultural
groups, members of all such groups cannot
escape the influence of the overarching national culture.
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A fourth influence on the lives of people is regional culture. In
many countries, individuals identify not just
with the national culture but also with the cultures of specific
parts of their countries. For example, Americans
who live along the U.S.–Mexico border may feel as Mexican as
they do American. Many such residents speak
Spanish and enjoy the food, music, and way of life common to
Mexico. Regional cultures are evident in many
African countries. In the north of Nigeria, where the country
borders Niger, the Housas, one of the country’s

largest ethnic groups, straddle the border that separates the two
countries, thereby causing the same regional
culture to exist in both countries.
The final layer is racio-ethnic culture. It is based on the
recognition that racially or ethnically different groups
often reside in areas separate from those in which a country’s
dominant racial or ethnic group live. People
inhabiting such racial or ethnic enclaves usually develop and
maintain cultures that are unique to the
communities in which they live. Although citizens of and
participants in the national culture, they may also
identify strongly with their racial or ethnic group and its way of
life. For example, because of their slave
heritage, African Americans have developed and continue to
maintain a culture that is in many ways different
from the national culture. Many institutions, such as the Black
church, which dates back to slavery, contribute
to the continuation of a “Black culture” in some communities.
The fivefold concentric conception of culture indicates that
people are the products of several influences over
which they have little or no control. No individual should be
considered only a member of a single national,
racial, or ethnic culture. People are often simultaneously
members of several cultures—they are individually
multicultural. Even so, across all cultures, people are more alike
than they are different. Counselors who
recognize the commonalities that humans share are apt to be
more effective in helping all clients than those
who focus on perceived cultural differences. Universal and
ecological cultures unify the human group more
than regional, national, or racio-ethnic differences separate the
species.
Readers who compare this seventh edition of Counseling Across

Cultures with the earlier editions will be able to
appreciate how much the study of culture and counseling has
evolved over the years. One thing that I notice is
how many more clienteles described as needing cross-cultural
intervention exist today than in 1973. Culture is
no longer just an esoteric concept discussed in sociology classes
and texts. It has now become an idea
appreciated, espoused, expanded, and exploited by most
counselors and counselor educators. In graduate
school, I mentioned to my major professor an interest in writing
my dissertation on a topic related to the
effect of culture on the outcomes of counseling. He discouraged
me from pursuing that research topic and
added, “Everybody knows that counseling is counseling.”
Feeling downhearted, I pursued a dissertation topic
more in keeping with his view of what was an appropriate
research idea. However, since receiving the PhD in
1965, I have written countless articles, chapters, and books on
how culture influences the counseling process.
Culture has become the linchpin of counseling throughout the
world.
Having devoted my career to studying the relationship of
culture and counseling, I am understandably pleased
to write the foreword to this significant contribution to the
increasingly large literature on cross-cultural
counseling. The seventh edition of Counseling Across Cultures
is a historical landmark. It is noteworthy because
it, along with the previous editions, provides a long view of
culture and counseling as they have evolved in a
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rapidly changing profession. It is evident that culture has taken

on a more inclusive meaning today than it had
more than 50 years ago, when I was in graduate school. Then,
some of my sociology professors talked
unabashedly about certain segments of our society being
culturally “deprived” or “disadvantaged.” Being the
only African American in most of my classes, I was shocked
and hurt to hear such assertions, because I had
learned in undergraduate school that everybody has a culture. I
now understand that my professors were
talking about the culture of White Americans. It was their way
of being, not that of most Americans of
Native, Asian, African, or Hispanic descent, or a host of other
citizens who were identified with a hyphen in
their group designations to set them apart from the dominant
cultural group.
Counseling has also evolved since the formation of the
American Counseling Association in 1952 as the
Personnel and Guidance Association. Subsuming the National
Vocational Guidance Association, the
National Association of Guidance and Counselor Trainers, the
Student Personnel Association for Teacher
Education, and the American College Personnel Association, the
newly formed organization extended the
work of social workers, teachers, and vocational counselors.
Today, ACA consists of 20 chartered divisions
and 56 branches in the United States and abroad. The divisional
membership breakdown usually reflects the
clienteles in which the various professionals specialize.
Moreover, there are wide variations in how counselors
identity themselves. Some see themselves as guidance
counselors similar to how most school counselors saw
themselves in the 1950s. Others consider themselves
psychologists. Still others identify with psychiatrists. In
spite of the broad definitions of culture and counseling and the
wide range of counselor identifications,

multiculturalism became what Paul Pedersen calls the “fourth
force” in counseling. It continues to be the most
important thrust of counseling in the 21st century. This new
edition of Counseling Across Cultures is, in effect,
a status report on this very important aspect of counseling. The
chapters in this book were written by some of
the most outstanding counseling authorities in the United States
and abroad. The information contained in
them is a godsend for graduate students, professors, and
therapeutic professionals working in a variety of
settings.
Clemmont E. Vontress, PhD
Professor Emeritus of Counseling
George Washington University
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Our Deepest Thanks to Paul B. Pedersen—Friend, Scholar, and
Gentleman
Paul Pedersen’s fervent passion about counseling across
cultures began at a time when few psychologists and
mental health practitioners considered the importance of the
cultural dimension in any significant way. The
inclusion and subsequently the infusion of the cultural
dimension in counseling and clinical psychology
became a longtime commitment for Paul when he was a
graduate student and quite possibly even before then.
In the late 1960s, Paul developed and carefully nurtured what he
eventually called the triad training model of
counseling, which emphasized the training of counselors in

settings where cultural similarities and differences
were the centerpiece for counselor education. It was
controversial at the time, yet it resonated with many who
were the early innovators and leaders in the emerging field of
cross-cultural psychology. In essence, Paul
describes triad training as a self-supervision model in which the
counselor processes both positive and negative
messages a client is thinking but not saying in counseling.
Articulating these hidden messages and checking
out their validity helps the counselor (1) see the problem from
the client’s viewpoint, (2) identify specific
sources of resistance, (3) diminish the need for defensiveness,
and (4) identify culturally resonant recovery
skills.
If there was a pivotal moment in the history of counseling
across cultures, it happened at the 88th annual
convention of the American Psychological Association, held in
September 1980 in Montreal, Canada. Paul
organized what we believe was the first, and certainly the most
visible, symposium focusing on counseling
across cultures. The hour-long symposium involved several
psychologists who were making seminal
contributions to the field, including Edward Stewart, Walt
Lonner, Julian Wohl, Joseph Trimble, Juris
Draguns, and Clemmont Vontress. In 60 short minutes the panel
discussed various cross-cultural counseling
topics. Eventually all of the panelists wrote chapters for the
seminal cross-cultural counseling textbook that we
now present in its seventh edition—what we believe to be a
record for a book of its kind.
Paul’s career-long commitment to promoting the importance of
culture in psychology was sparked by his early
travels hitchhiking across Europe and his academic
appointments beginning in 1962 as a Visiting Lecturer in

Ethics and Philosophy and the Chaplain at Nommensen
University in Medan, Sumatra, Indonesia. He
studied Mandarin Chinese full-time in 1968 in Taiwan. From
1969 to 1971, Paul was a part-time Visiting
Lecturer in the Faculty of Education at the University of
Malaya; also, he was the Youth Research Director
for the Lutheran Church of Malaysia and Singapore. While in
Indonesia and Malaysia Paul quickly realized
that what he had learned about conventional counseling in
graduate school didn’t accommodate the
worldviews of Malaysians, Chinese, and Indonesians, among
many others. The daily dose of rich and deep
cultural experiences combined with the challenges associated
with understanding culturally unique lifeways
and thoughtways quietly planted the seeds for his plans to
develop, advocate, and promote the value and
significance of considering cultural differences in the
counseling and clinical psychology professions.
In 1971, Paul accepted the position of Assistant Professor in the
Department of Psycho-educational Studies
at the University of Minnesota in Minneapolis; he also held a
joint appointment as an adviser in the
19
International Student Office. Drawing mainly on his experiences
in Indonesia, Malaysia, and Taiwan and his
daily counseling sessions with international students at
Minnesota, Paul became increasingly concerned about
the relevance of conventional counseling approaches and began
to consider more culturally sensitive
counseling strategies. As an alternative to the use of

conventional counseling education approaches, Paul
devised and implemented his aforementioned triad training
model.
In 1975, Paul became a Senior Fellow at the Culture Learning
Institute at the East-West Center in
Honolulu, Hawaii. In 1978–1981, he was director of a large
predoctoral training grant from the U.S. National
Institute of Mental Health titled Developing Interculturally
Skilled Counselors. With eight predoctoral
trainees, Paul conducted training programs that emphasized
cross-cultural counseling approaches through use
of the triad training model. Paul closely maintained his
Hawaiian appointments and ties for the rest of his
illustrious career by serving as a Visiting Professor of
Psychology at the University of Hawaii, Manoa, and as a
Fellow at the East-West Center.
In 1982, Paul accepted an appointment at Syracuse University
as Professor and Chair of the Department of
Counselor Education. In 1995, he earned the title of Professor
Emeritus at Syracuse and subsequently became
a Professor in the Department of Human Studies at the
University of Alabama, Birmingham. In 2001, after a
year as a Senior Fulbright Scholar at Taiwan National
University, Paul formally retired from academic life and
moved back to his much beloved Hawaii to continue his writing,
traveling, and scholarly interests. He
retained his appointment as a Visiting Professor in the
Department of Psychology at the University of Hawaii,
Manoa.
Paul’s remarkable career includes the publication of more than
40 books and more than 150 book chapters and
journal articles; the concept of culture is the common thread
that runs through all of them. In reviewing Paul’s

extraordinary accomplishments, one quickly realizes that he is
imaginative, farsighted, and truly a pioneer in
the field of multicultural counseling.
Scholars in the counseling and psychotherapy fields generally
consider Paul’s edited book Multiculturalism as a
Fourth Force, published in 1999, to be a milestone in the history
of psychology. The book surveyed the
prospect that we are moving toward a universal theory of
multiculturalism that recognizes the psychological
consequences of each cultural context. Paul and his colleagues
argued that the fourth force supplements the
three forces of humanism, behaviorism, and psychodynamism
for psychology.
Service to the professional community is an important value for
Paul, and thus he has found time to serve on
numerous boards and committees. His activities have included 3
years as President of the Society for
Intercultural Education, Training and Research (SIETAR),
Senior Editor for the SAGE Publications book
series Multicultural Aspects of Counseling (MAC), and
Advising Editor for a Greenwood Press book series
in education and psychology. Additionally, Paul is a Board
Member of the Micronesian Institute, located in
Washington, D.C., and an External Examiner for Universiti
Putra Malaysia, University Kebangsaan, and
Universiti Malaysia Sabah in psychology. In the American
Psychological Association, Paul was a member of
the Committee for International Relations in Psychology (CIRP)
from 2001 to 2003. In 2010 he was the
recipient of CIRP’s Distinguished Contributions to the
International Advancement of Psychology Award. In
20

1994 he was invited to give a master lecture at the Ameri can
Psychological Association’s annual meeting in
Los Angeles. Paul also is a Fellow in Divisions 9, 17, 45, and
52 of the American Psychological Association.
About a decade ago Paul was unfortunately stricken with
Parkinson’s disease. His mental abilities and all of
his fine personal qualities remain intact, but the affliction has
affected his vision and ability to type or use
computers effectively. With Paul’s permission, we want all who
do not yet know about his condition to
understand why his work on this edition of Counseling Across
Cultures has been somewhat curtailed. In
discussing this with Paul we lamented the fact that in this
edition there is no chapter that deals directly with
what could be called something like the “culture of the
afflicted.” Chapters 19 and 20 get into some of these
concerns and matters, dealing as they do with health issues.
However, Paul reminded us of an intuitively
insightful fact: When one is burdened with a physical condition
that has no known cure—Parkinson’s is an
excellent and tragic example—one enters a new and entirely
unexpected culture. Adjustments must be made,
old and familiar abilities must be replaced by new ones, and
one’s interpersonal network can be radically
changed. In a very real sense, then, Paul’s condition has given
him, through us, the opportunity to seize
another “teaching moment.” Paul, a magnificent teacher and
adviser throughout his career and this project,
would appreciate that characterization.
By all professional and personal standards, Paul is a visionary.
He has contributed significantly to the
emergence of multiculturalism in psychology and in related

disciplines. His commitment to multiculturalism
extends well beyond the mental health professions. In thinking
about the future of multicultural counseling
and social justice, Paul firmly believes that the multicultural
perspective will evolve into a perspective that
acknowledges how people may share the same common-ground
expectations, positive intentions, and
constructive values even though they express those expectations
and positive intentions through different and
seemingly unacceptable behaviors. He also maintains that we
must generate a balanced perspective in which
both similarities and differences of people are valued and at the
same time hope we can avoid partisan
quarreling among ourselves and get on with the important task
of finding social justice across cultures.
We dedicate this seventh edition of Counseling Across Cultures
to our dear friend and colleague Paul Bodholdt
Pedersen, a true trailblazer, mentor, and leader in making
counseling cultural.
Walter J. Lonner
Juris G. Draguns
Joseph E. Trimble
21
Introduction Learning From Our “Culture Teachers”
This seventh edition of Counseling Across Cultures is largely

guided by the fundamental premise that it shares
with most books at the interface of social realities and
psychological principles: All behaviors and thoughts are
learned in specific cultural contexts. If you can accept that
simple premise you are ready to tackle one that is
much more complex: While people are much more similar than
they are different, the differences are
fascinating and sometimes difficult to understand without
considerable exposure to and interaction with
people from different cultures and ethnic groups.
How do these similarities and, especially, differences come
about? Paul Pedersen has used a colorful image
that is based on the idea that all humans have “culture
teachers,” and while some of these teachers have similar
characteristics, each is also totally unique. Capture, suggests
Pedersen, a panorama of a thousand persons
sitting around you. The large gathering consists of some people
you have chosen, or who have chosen you,
over a lifetime of many interactions. This gathering of people
includes parents, siblings, grandparents, close
friends, teachers, enemies, heroes, heroines, scientific pioneers,
religious figures, political leaders,
revolutionaries, poets, entertainers, athletes, individuals with
disabilities, and many others who have
influenced you in sometimes subtle but often profound ways.
Either directly or indirectly, they have all helped
to shape who you are. They will likely continue to do so, even
those who have been dead for years. Getting to
know another person well is a riveting, complex, and exhausting
process, but it can also be exhilarating and
fulfilling.
We believe, therefore, that before we can make accurate
assessments, provide meaningful understanding, and
offer appropriate interventions, we must learn more about our

own cultural contexts and the culture teachers
who shaped our lives. Reciprocally, in interactions with
others—and especially in counseling and therapeutic
relationships—it is imperative that we learn as much as we can
about each person with whom we interact. To
ignore an individual’s “culture teachers” and the cultural
context that shaped his or her life is to invite little or
no progress in professional interventions. You are probably
reading this book because, either intuitively or
from direct experience, you already know this to be true.
Moreover, you probably agree with us that it would
be impossible for a counselor to know, in depth and in great
detail, everything about all clients with whom he
or she interacts. However, by using the precepts of inclusive
cultural empathy (ICE), which is a theme
running through this book and a concept explained in Chapter 1,
we can emphatically endorse the idea that
we try to understand each and every client. Such understanding
does not necessarily have to be in great depth.
In many cases it may be close to impossible to understand the
worldviews, values, and background of a client
in a short period of time. It may be difficult to fathom the plight
of a homeless person, or an immigrant from
Vietnam, or a transvestite, or a religious zealot. Despite these
scenarios and hundreds others like them, it is
imperative that we employ ICE and make a sincere attempt to
know the other person, even if it is “through a
glass, darkly.” Consistent with the demands of what can be a
challenging task, it is our job as the editors of
this volume, as well as the job of the chapter authors, to help
hone your skills and talents in our shared
kaleidoscopic multicultural world. All the chapters in this book
have been written by dedicated professionals
who can inform and advise you. Welcome them all as
newcomers to your circle of “culture teachers.” Covet

22
their advice.
Since the first edition of Counseling Across Cultures was
published in 1976, thousands of publications and
research projects have increased our understanding of the roles
of culture teachers. Many of these sources are
listed in the reference sections of the chapters in this book. We
owe a great debt to our culture teachers for the
wisdom we have gained from them, and we are pleased to
introduce them to you. As recently as 1973, when
we presented a seminal symposium at the American
Psychological Association titled “Counseling Across
Cultures” and subsequently planned the first edition of this
book, the terms cross-cultural and multiculturalism
were largely neglected or unknown to counseling professionals.
The University of Hawaii Press agreed to
publish that initial book, provided we waived royalties. The
book went through five printings the first year
and then through five more editions—in 1981, 1989, 1996,
2002, and 2008. This, the seventh edition, gives
testimony to the continued popularity of counseling across
cultures, which has evolved into a burgeoning and
multifaceted enterprise.
The culture-centered or multicultural perspective provides us
with at least 12 uniquely valuable goals and
outcomes:
1. Accuracy: All behaviors are learned and displayed in specific
cultural contexts.
2. Common ground: The basic values in which we believe are
expressed through different attitudes,

behaviors, and worldviews across cultures and ethnic groups.
3. Identity: We learn who we are from the thousands of culture
teachers in our lives as we integrate these
multiple threads of experience.
4. Health: Our socio-ecosystems require a diversified gene pool.
5. Protection: Psychology has been culturally encapsulated
through much of its history, and we need to
identify our own biases to protect ourselves from failure.
6. Survival: Our best preparation for life in the global village is
to learn from persons who are culturally
different from ourselves.
7. Social justice: History documents that injustices can be
expected when a monocultural, dominant group is
allowed to define the rules of living for everyone; shifting to a
multicultural orientation curbs this
tendency.
8. “Out of the box” thinking: Progress in understanding the
problems of others is often constrained by
traditional linear thinking; we should frequently consider
nontraditional, nonlinear alternatives. A
multitude of insiders’ and outsiders’ perspectives can help us
develop a more differentiated and flexible
view of the world.
9. Learning: Effective learning that results in change is also
likely to result in our both experiencing and
overcoming culture shock and adapting to innovation and
transformation.
10. Spirituality: All humans experience the same Ultimate

Reality in different ways; there is no single “right”
way, and it is ethnocentric folly to assume that there is.
11. Political stability: Some form of cultural pluralism is the
only alternative to either anarchy or oppression.
12. Competence: Multiculturalism is generic to a genuine and
realistic understanding of human behavior in
all counseling and communication.
23
Above and beyond these 12 points, culturally informed
counseling can be likened to a bridge that helps
transcend the gulf or chasm of differences in practices,
expectations, and modes of communication that
separate persons whose backgrounds and outlooks have been
molded by their respective cultures. That is the
reason a photo of a bridge adorns the cover of this book.
Effective multicultural counseling will likely not
obliterate the need for the bridge, but it may shorten the journey
substantially.
The present edition includes many new authors and a new
coeditor—52 individuals in all—and offers ideas
that have emerged since the appearance of the sixth edition,
which was published in 2008. Like the sixth, this
edition is divided into five parts and a total of 24 chapters. Each
part opening features an introduction that
briefly surveys the content of the chapters within the part. All
chapters begin by identifying primary and
secondary objectives, and all (with the exceptions of Chapters 1
and 2) include “critical incident” discussions
to illustrate key points at the hypothetical case level. Most of

the critical incidents are highlighted at the ends
of the chapters, but some are integrated into the text in other
ways. Discussion questions are also included.
We concede that not all of the incidents presented are critical in
the strict sense of the term. All are, however,
designed to make abstract concepts concrete and to exemplify,
often in a vivid way, the interface between
culture and counseling. In addition to this feature, the
contributors to the present edition have been liberal in
describing instances and offering vignettes of culturally
distinctive ways of presenting personal dilemmas,
seeking relief from distress, and, in the optimal case, reducing
suffering and resolving quandaries and
problems of living. On the theoretical plane, the authors of
these chapters have contributed several explicit
models of culturally sensitive intervention in a variety of
contexts. Moreover, the results of several major
multinational research projects have been brought to bear on the
current multicultural counseling enterprise.
In this manner, the contributors to this volume have endeavored
to narrow the gap between basic cross-
cultural research findings and culturally appropriate
intervention at the case level.
In what ways is the current edition different from its
predecessors? For one, it is more case centered. As
already alluded to above, several of the chapter authors have
gone well beyond critical or illustrative incidents
to build their contributions around a limited number of detailed
case studies, an approach that has enabled
them to explore cultural issues in counseling in depth. For
example, Chapter 20 includes a detailed account of
a client overcoming clinical problems by recapturing the themes
and values of his original culture. In the
process of presenting this account, the authors bridge the gap
between culture teaching and therapy. Chapter

23 highlights the traumatic effect of culture loss, or
deculturation, and, conversely, demonstrates how the
previously suppressed strands of cultural experience may help a
counselee achieve more effective functioning
and more rewarding experience. Chapter 14 relates the
experiences of two international students as they seek
and find their way through the maze of the host culture,
illustrating the vicissitudes of culture learning and the
impact of a multiplicity of culture teachers.
The second theme that receives increased emphasis in the
current edition is that of promotion of social justice.
There was a time when many counseling and mental health
professionals considered their interventions to be
sharply distinct, or even mutually exclusive, from the work of
the advocates for persons in various
disadvantaged, oppressed, or poorly understood cultural
categories. The recognition that the reformist and the
therapeutic thrusts of improving the lives of culturally
distinctive counselees are compatible and mutually
24
complementary pervades this edition, and is especially
prominent in Chapters 5–9, 10–11, and 14–17.
A third theme that is also highlighted in this edition is the
importance of considering and examining the
intersectionality of identities, privileges, and oppressions. Many
of the chapters challenge the reader to
critically examine and consider the impacts of intersecting
systematic oppressions and privileges in themselves
and in their clients as a key step in ICE. Becoming aware of our
own privileges and how they affect our lives

and our clinical work can be an overwhelming task. Privilege
protects those of us who hold it from a lot of
psychological struggle (i.e., not having to deal with external
and internalized oppression), but it also robs us of
gaining knowledge about the world and about ourselves in
relation to the world. Privilege is a blind spot in
our awareness that slows down the road toward ICE; thus, many
of the chapters in this book provide readers
with information and questions that can help them to bridge this
gap in awareness, knowledge, and empathy.
Concurrent with the promotion of ICE, this edition also
emphasizes the increasing role of culturally adapted
evidence-based procedures, a topic to which Chapter 4 is
principally devoted. In several other chapters, the
authors describe specific evidence-based procedures that have
been successfully applied in various domains of
counseling across culture. As these approaches spread and
multiply, the challenge is to combine demonstrated
effectiveness with empathetic cultural sensitivity, fusing
subjectivity with objectivity. Not an easy task, to be
sure, but not an unattainable goal either.
Although this edition introduces many new topics and
approaches, it also reaffirms the relevance of major
contributions from earlier editions. In the fourth edition of
Counseling Across Cultures, David Sue and Norman
Sundberg contributed an important chapter titled “Research and
Research Hypotheses About Effectiveness in
Intercultural Counseling.” It contained 15 research hypotheses
that have held up remarkably well across the
intervening decades. For that reason, we reproduce them here:
1. Entry into the counseling system is affected by cultural
conceptualization of mental disorders and by the
socialization of help-seeking behavior.

2. The more similar the expectations of the intercultural client
and counselor in regard to the goals and
process of counseling, the more effective the counseling will be.
3. Of special importance in intercultural counseling
effectiveness is the degree of congruence between the
counselor and client in their orientations in philosophical values
and views toward dependency,
authority, power, openness of communication, and other special
relationships inherent in counseling.
4. The more the aims and desires of the client can be
appropriately simplified and formulated as objective
behavior or information (such as university course requirements
or specific tasks), the more effective the
intercultural counseling will be.
5. Culture-sensitive empathy and rapport are important in
establishing a working alliance between the
counselor and the culturally different client.
6. Effectiveness is enhanced by the counselor’s general
sensitivity to communications, both verbal and
nonverbal. The more personal and emotionally laden the
counseling becomes, the more the client will
rely on words and concepts learned early in life, and the more
helpful it will be for the counselor to be
knowledgeable about socialization and communication styles in
the client’s culture.
25
7. The less familiar the client is with the counseling process,

the more the counselor or the counseling
program will need to instruct the client in what counseling is
and in the role of the client.
8. Culture-specific modes of counseling will be found that work
more effectively with certain cultural and
ethnic groups than with others.
9. Ethnic similarity between counselor and client increases the
probability of a positive outcome.
10. Within-group differences on variables such as acculturation
and stage of racial identity may influence
receptivity to counseling.
11. Credibility can be enhanced through acknowledgment of
cultural factors in cross-cultural encounters.
12. In general, women respond more positively than men to
Western-style counseling.
13. Persons who act with intentionality have a sense of
capability and can generate alternative behaviors in a
given situation to approach a problem from different vantage
points.
14. Identity-related characteristics of White counselors can
influence their reaction to ethnic minority
clients.
15. Despite great differences in cultural contexts in language
and the implicit theory of the counseling
process, a majority of the important elements of intercultural
counseling are common across cultures and
clients.
The infusion of multiculturalism into the theory and practice of
counseling is a long process that requires the

understanding of “new rules.” Clients in counseling and
psychotherapy come from a multitude of cultures and
ethnicities, each with his or her own unique assortment of
culture teachers. The imposition of a one-size-fits-
all approach to counseling is no longer acceptable for clients
who represent a substantial number of diverse
cultural contexts. The counselor who thinks there are only two
people involved in a transaction—the client
and the counselor—is already in great difficulty.
In addressing these wide-ranging and key issues, we seek to
articulate in this volume the positive contributions
that can be realized when multicultural awareness is
incorporated into the training of counselors. Properly
understood and applied, this awareness of our culture teachers
will make our work as counselors easier rather
than harder, more satisfying rather than frustrating, and more
efficient rather than inefficient and
cumbersome.
Paul B. Pedersen
Walter J. Lonner
Juris G. Draguns
Joseph A. Trimble
26
27

Part I Essential Components of Cross-Cultural Counseling
A quick look at the table of contents of this text reveals that
almost 80% of the chapters—the 20 chapters that
make up Parts II through V—focus on specifically targeted
perspectives and topics that are systematically
spread across important clusters of interrelated chapters. Thus,
the operative phrase that they share is specificity
of function. All of these 20 chapters feature topics that can, if
one desires, be read as unified independent
presentations. For instance, if a counselor wishes to review key
aspects of counseling Asian clients, or refugees,
or issues pertaining to families, specific chapters can serve as
informative packages in and of themselves. The
operative phrase in Part I, in contrast, is foundational
perspectives. The intent of this beginning group of four
chapters is to provide a broader view that will help form a
coherent basis for the rest of the text. We strongly
believe that all approaches used in cross-cultural counseling are
best implemented when important generic
areas, fundamentally related to all other counseling-oriented
topics, are woven into the fabric of counselors’
specific purposes. In that sense, Part I has an integrative
function for the text. We recommend reading it first.
In this introduction we present only fragmentary comments on
the four chapters.
Chapter 1 focuses on inclusive cultural empathy, or ICE.
Empathy, like related concepts such as sympathy
and compassion, is a human universal. It has almost certainly
been part of the collective human psyche across
countless millennia. A temporary state of emotional symbiosis
seems to characterize empathy. One has only to
study Rembrandt’s 17th-century masterpiece The Return of the

Prodigal Son to see and even feel that acts of
empathy, compassion, and sympathy predate the introduction of
the root German word Einfühlung, which
means “in-feeling” or “feeling in.” It was first used more than a
century ago in the psychology of aesthetics.
Robert Vischer and then Theodor Lipps introduced it as an
interpersonal phenomenon. Freud and others
employed the term extensively. Thus it is useless to argue
whether or not we have the capacity for empathy.
Rather, the question is, To what extent do we have it? That
leads to other questions, such as Can it be
enhanced by experience and training? and Is too much of this
“feeling in” dangerous in counseling
relationships?
Culture-oriented perspectives in psychology are currently
popular and inclusive, and we believe they will
remain that way. Whether it is cross-cultural psychology,
cultural psychology, indigenous psychology,
psychological anthropology, or multiculturalism, psychology
has become much more inclusive. Gone are the
hegemonic days of Western-based psychology that largely
ignored the phenomenon of culture and its
multitude of forms. “Leave culture in the hands of
anthropologists” was a frequent directive issued by
orthodox behaviorists. That narrow vision has almost entirely
disappeared. Many of the basic principles of
psychology remain, as well they should, because psychology is
an important academic and practical discipline
with transcendent conceptual and methodological principles.
Organized cross-cultural psychology, one of the
antidotes to scholarly myopia, is now half a century old, with
new developments certain to continue. (For a
chronological overview of initiatives that have been heavily
influenced by culture-oriented psychologists, see
Lonner, 2013.) Inclusive cultural empathy is a concept that

stands on the shoulders of these efforts. ICE is
such a compelling idea that it serves as the hub for the several
spokes that constitute the remaining chapters in
this text. In Chapter 1, Paul B. Pedersen and Mark Pope take the
experience of empathy, with its roots in
28
Western conceptualizations of self, values, and other popular
constructs that make up personhood, to a level
made possible by the contributions of thousands of
psychologists and counselors throughout the world.
Pedersen and Pope note that “inclusion” comes from research in
the hard sciences, where something “can be
both right and wrong, good and bad, true and false at the same
time through ‘both/and’ thinking.” This
supplants the rules of “exclusion,” which, as they point out,
have depended on “either/or” thinking, wherein
one alternative explanation is entirely excluded and its opposite
is entirely accepted. Thus, “from this quantum
perspective, empathy is both a pattern and a process at the same
time.” It is elegantly clear, therefore, that in
counseling across cultures, taking both the perspective of the
counselor and that of the client, much more can
be gained by adopting a two-way attitude than by accepting a
traditional “either/or” perspective.
Psychotherapy is not a laboratory experiment in which a null
hypothesis is either accepted or rejected. This
dichotomy would mean that accepting one perspective (usually
the counselor’s) over the other would block
progress. No doubt thousands of counseling sessions have ended
abruptly when one in the dyad (usually the
counselor) looked at the problem through culture-colored

glasses. It was out of these procedural concerns that
Pedersen developed his well-known triad training model. ICE is
also central to Pedersen’s idea that
multiculturalism is a “fourth force” in psychotherapy and, as
such, is as influential as behaviorism, humanism,
and psychodynamic approaches. These pioneering viewpoints
are briefly discussed in Chapter 1.
The intent of Chapter 2 is to examine the basic elements of
counseling and to explain how counseling in any
cultural setting can be effective. In the chapter, Juris G.
Draguns gives examples of classic definitions of
counseling, all of which can readily be applied to counseling
across cultures. The idea that “counseling is
principally concerned with facilitating, rather than more
directively bringing about, adaptive coping in order
to alleviate distress, eliminate dysfunction, and promote
effective problem solving and optimal decision
making” is sufficiently transcendent to be used in any
relationship that can be described as “counseling.” An
additional comment Draguns makes, that “counseling proceeds
between two (or sometimes more than two)
individuals and is embedded in distinctive sociocultural
milieus,” correct as it is, must be considered in
connection with ICE, for two, and not just one, cultural milieus
will inevitably be involved. This is the sauce
that gives meaning to the notion of “cross” in cross-cultural
counseling, for these relationships cut both ways.
Draguns gives cogent examples of what Pedersen has told us:
that a multitude of “culture teachers” have
strongly influenced, and continue to influence, all culture-
oriented counselors. Like homunculi sitting on a
counselor’s shoulder during counseling sessions, these teachers
affect what is said and done in each and every
encounter. This analogy is in line with the broad sweep of ICE.

The more influence these teachers have in a
counseling session, the more likely it is they will contribute to a
successful outcome. Another consideration of
empathy is that it works best if understood as a constantly
reciprocating relationship. The counselor will have
to be attuned to the many ways that the client has learned his or
her own culture, and the client will have to
pay attention to what the counselor says and does, for just as
the counselor has “culture teachers,” so does the
client. This is part of what the therapeutic alliance is all about.
Chapter 2 also covers a range of other considerations that to
varying degrees cut across all the other chapters
in the text. Culturally adapted cognitive-behavioral therapy and
its possible convergence with evidence-based
29
treatments have entered culture-oriented counseling. The issues
surrounding this convergence are discussed.
The latter part of the chapter shifts from the nature of cross -
cultural counseling as a process that differs from
“routine” counseling to several generalizable characteristics of
clients. While it is true that each individual is
unique, there are certain domains of personhood that transcend
culture and ethnicity. Foremost among these
domains is the construct of self. Consistent with aspects of self
that are important in assessing persons (see the
discussion below regarding Chapter 3), in culture-oriented
counseling it is important to keep in mind that the
nature of a client’s self is largely shaped by cultural and ethnic
factors that leave their indelible imprints on
everyone. The most widely researched aspect of the self places
all of us on a continuum. On one end we find

those who are highly independent and autonomous in thought
and action (think of the stereotypic strong
male, or of the notion of self-sufficiency). The other end is
populated by individuals whose selves are
conditioned by a strong sense of belonging to some sort of
collectivity, such as a caste, clan, family, or other
group (think of the stereotypic female, for whom family,
friends, and community come first). The continuum
of allocentrism–idiocentrism—or group orientation as opposed
to self-reliance—has been used as another way
to view opposing configurations of personality traits that help
explain how individuals differ. Highly related to
this useful concept is the dichotomy of individualism and
collectivism. A number of culture-oriented
psychological researchers have spent most of their careers
studying the roots and dynamics of this hypothetical
continuum, which is mostly used at a high level of abstraction,
such as a clan or an entire country. It is such a
robust construct that one can envision it as being highly related
to the bifurcation of extroversion and
introversion, an oft-used dichotomy that operates at the level of
the individual. Draguns also discusses four
other dimensions that Hofstede and a large network of fellow
researchers have used in hundreds of research
projects. He closes the chapter by discussing universal, cultural,
and individual threads in counseling. He also
includes a helpful list of brief “dos and don’ts” that can help
guide counselors in their interactions with clients
whose cultural or ethnic backgrounds differ from their own.
Chapter 3 gives an overview of issues, problems, and
perspectives in the area of psychological assessment. The
assessment or appraisal of a person who, for any reason,
becomes a counseling client begins the instant that
counselor and client meet. The assessment can be quick and
impressionistic, involving no formal assessment

procedures. On the other hand, it can, and usually does, involve
an array of psychological tests and other
measurement devices and procedures that help the counselor
understand the client’s abilities, personality,
values, and virtually any other dimension of personhood that the
counselor deems important. Perhaps the key
question to be asked and answered is the one that the author of
the chapter, Walter J. Lonner, proposes: Is the
assessment of this person, in these circumstances, with these
methods, and at this time as complete and accurate
as possible?
The field of psychological measurement and testing has a rich
and lengthy history, and it is one of the more
ubiquitous areas in the discipline. Lord Kelvin once made a
claim that cements the importance of tests and
measurements: “If you haven’t measured it you don’t know
what you are talking about.” Years later, E. L.
Thorndike backed him up with this well-known proclamation:
“If a thing exists, it exists in some amount; and
if it exists in some amount, it can be measured.” Thus, one
dimension in assessment—and arguably the most
important in the area of professional counseling—involves
carefully planned psychological testing. All
counseling clients, regardless of presenting problems and the
focus of counseling, are assessed in some fashion,
30
and many of them will be required or asked to take one or more
psychological tests. Tests that measure
aptitude, abilities, intelligence, personality, interests, values,
and other aspects of the person are most
common. Most of these psychometric devices originated in the

United States, Canada, and their territorial
extensions, such as Great Britain, Australia, New Zealand, and
Western Europe. Furthermore, most of them
were originally conceived by academic psychologists and
educational experts who represent a fairly narrow
swath of vast populations and normed on “captive audiences” or
“samples of convenience.” And therein lies a
question that begs an answer in almost any counseling
encounter with people for whom the tests may not have
been originally normed: What must be done to ensure that the
test results are equivalent and unbiased? The
ideas of fairness and cultural validity are pervasively on the
minds of cross-cultural psychologists, whose
careers have been dedicated to the assessment of various
dimensions of personhood. As Lonner points out,
numerous technical resources are readily available in the
literature to help therapists translate and otherwise
adapt psychological tests for use in counseling.
Counselors can choose between quantitative (nomothetic) and
qualitative (idiographic) methods in assessment
or use some combination of the two. Because both of these
approaches have attractive features, the use of
mixed methods is steadily increasing, especially in counseling
and clinical work. Neuropsychological testing,
briefly surveyed in Chapter 3, is often important in the
assessment of acculturating or displaced individuals
who have been victims of wars, physical or psychological
abuse, malnutrition, or other horrid human
conditions.
The overriding theme of inclusive cultural empathy that
characterizes this book can be extended to inclusivity
in empathetic assessment. For this reason, Lonner suggests the
use of knowledge-based assessment (KBA).
Usually having nothing to do with more traditional and formal

assessment devices, KBA includes the
knowledge that the counselor has accumulated in all walks of
life and especially from reading and becoming
familiar with culture-oriented research that, for years, has
focused on hypothesized universal personality traits
and the ways in which culture helps to shape various dimensions
of self as well as values. A client’s personality,
conceptions of self, and preferences for certain values over
others will always be among the mixture of things
that emerge in the process of counseling. The counselor’s
ability to use the results of a great deal of culture-
driven research in such areas of personhood extends the notion
of psychological assessment beyond its more
formal and traditional techniques.
Counseling across cultures as a recognized professional activity
has a lengthy history but a short past. One can
imagine thousands of scenarios in the distant past where a
person from, for example, Homer, Alaska, was
discussing a personal problem presented by an immigrant from
rural Norway. The counselor may have little or
no psychological background, and both the counselor and the
client may have limited fluency in the other’s
language. These kinds of conundrums take us back a few pages
in this introduction to our brief discussion of
assessment across cultures. Thus, in this hypothetical context,
one can ask: Is my counseling of this person, in
these circumstances, with the methods at my level of
competence, and at this time and place as practicable and
ethical as possible? The authors of Chapter 4 ask this
multifaceted question in the context of a fundamental
issue in multicultural counseling—an issue that transcends all
20 chapters in Parts II–V. Timothy B. Smith,
Alberto Soto, Derek Griner, and Joseph E. Trimble summarize
the current status of research on multicultural

31
counseling. As they note, research in this area has increased
exponentially over the past several decades.
Clearly, even as recently as 1976, when the first edition of this
book appeared, very little research had been
conducted bearing on the effectiveness of counseling across
cultures. This is especially true with respect to
evidence-based psychological treatments, which are currently at
a premium.
Focusing primarily on the powerful method of meta-analysis, in
which the findings of numerous individual
studies are integrated prior to analysis in an effort to make
sense of the effectiveness (or lack thereof) of
counseling across cultures, Smith et al. look into the
characteristics of counselors who demonstrate
competence in the field. Intercultural competence is clearly the
silver chalice for anyone who aspires to reach a
recognized level of effectiveness in multicultural competence.
An increasing array of research and literature on
the topic is coalescing to an extent not heretofore reached. For
instance, in 2013 the Journal of Cross-Cultural
Psychology published a special issue containing nine articles
that are fine examples of current thinking in this
area (Chiu, Lonner, Matsumoto, & Ward, 2013). The issue
focuses on cross-cultural competence in general,
with a decided nod in the direction of cross-cultural competence
in the international workplace (among
managers, consultants, negotiators, and so on), and not
specifically multicultural counseling competence.
However, sensitivity, open-mindedness, social initiative,
flexibility, cultural empathy (which in this book is
essentially equivalent to ICE), critical thinking, emotional

stability, emotion regulation, awareness, abilities,
knowledge, and skills are descriptors that often surface in
attempts to pinpoint the components of cross-
cultural competence. It seems to us that if a person is cross -
culturally competent, that competence should
transfer well across all domains of interpersonal interaction.
The package of the above descriptors a person
possesses would, if realized in sufficient quantities, define ICE.
Numerous attempts to measure the concept
have been attempted (Deardorff, 2009; Matsumoto & Hwang,
2013).
While all chapters in this book can be enhanced and informed
by this foundational chapter, perhaps the
contribution that is closest to Chapter 4 conceptually and
practically is Chapter 18, which focuses exclusively
on acculturation, a topic that by definition is saturated with an
assortment of counseling needs. This is
especially true in North America, which for generations has
been the “promised land” for many. Smith et al.
mention this as well. A high percentage of the works cited in
the above-mentioned special issue come from
journals such as the International Journal of Intercultural
Relations; just a handful are journal articles and books
that typically are read by counselors and clinicians. With so
much to offer each other, readers of this text are
encouraged to do something about this unfortunate territorial
bifurcation. The latter pages of Chapter 4
discuss a number of factors that have been researched by
culture-oriented practitioners. They include racial
and ethnic matching of client and culture and ways in which
general theories of counseling have been adapted
for multicultural counseling.
32

References
Chiu, C. Y., Lonner, W. J., Matsumoto, D., & Ward, C. (Eds.).
(2013). Cross-cultural competence [Special
issue]. Journal of Cross-Cultural Psychology, 44(6).
Deardorff, D. K. (Ed.). (2009). The SAGE handbook of
intercultural competence. Thousand Oaks, CA:
Sage.
Lonner, W. J. (2013). Foreword. In K. D. Keith (Ed.), The
encyclopedia of cross-cultural psychology.
Hoboken, NJ: Wiley-Blackwell. (Also in Online Readings in
Psychology and Culture,
http://dx.doi.org/10.9707/2307–0919.1124)
Matsumoto, D., & Hwang, H. C. (2013). Assessing cross-
cultural competence: A review of available tests.
Journal of Cross-Cultural Psychology, 44(6), 849–873.
33
http://http://dx.doi.org/10.9707/2307%E2%80%930919.1124
1 Toward Effectiveness Through Empathy
Paul B. Pedersen
Mark Pope
34

Primary Objective
■ To provide an overview of the significance and importance of
inclusive cultural empathy
35
Secondary Objectives
■ To reframe the counseling concept of “individualistic
empathy” into inclusive cultural empathy
■ To develop a more relationship-centered alternative based on
Asian ways of knowing and healing
Good relationships in counseling psychotherapy emerge as a
necessary but not sufficient condition in all
research about effective mental health services. Good
relationships depend on establishing empathy. Empathy
occurs when one person vicariously experiences the feelings,
perceptions, and thoughts of another. Most of
the research on empathy is predicated on the shared
understanding of emotions, thoughts, and actions of one
person by another. In Western cultures, psychologists typically
focus exclusively on the individual, whereas in
traditional non-Western cultures, empathy more typically
involves an inclusive perspective focusing on the
individual and significant others in the societal context. This
chapter explores the reframing of “empathy,”
based on an individualistic perspective, into “inclusive cultural
empathy,” based on a more relationship-
centered perspective, as an alternative interpretation of the
empathetic process (Pedersen, Crethar, & Carlson,
2008).
The world has changed to make us totally interdependent on a
diversified model of society, requiring us to

find new ways of adaptation. Globalization, migration,
demographic changes, poverty, war, famine, and
changes in the environment have led to increased diversity
across the globe. Our responses to that diversity,
through sociotechnical changes, competition for limited
resources, and anger and resentment at the
intranational and international levels, all of which depend on
conventional Western models, have been
inadequate:
Powerful global efforts to reduce diversity conflicts by the
hegemonic imposition of Western
economic, political, and cultural systems is not a solution to the
emerging diversity conflict issues.
Rather, the “global monoculturalism” being promoted represents
an exacerbation of the problem as
evidenced by the growing radicalization of individuals, groups,
and nations seeking to resist the
homogenization pressures. (Marsella, 2009, p. 119)
In this context, empathy—reframed as inclusive cultural
empathy—provides an alternative perspective to
conventional individualism. We believe that psychologists are
part of both the problem and the solution to
this dilemma, and we call upon the field to take leadership
around the world in applying this inclusive cultural
empathy model.
36
Cultural Foundations
Moodley and West (2005) integrated traditional healing
practices into counseling and psychotherapy. They

described a rich healing tradition from around the world, going
back more than 1,000 years, that is being used
today alongside contemporary health care. They
explore the complexities of the various approaches and argue
for the inclusion and integration of
traditional and indigenous healing practices in counseling and
psychotherapy. This need to look
outside the boundaries of Western psychology is a direct result
of the failures of multicultural
counseling or the way psychotherapy is practiced in a
multicultural context. It seems that
multicultural counseling and psychotherapy is in crisis.
(Moodley & West, 2005, pp. xv–xvi)
Mental health care providers and educators can no longer
pretend that counseling and psychotherapy were
invented in the last 200 years by European Americans in a
Western cultural context. The recognition of
indigenous resources for holistic healing and the search for
harmony have been recognized in the literature
about complementary and alternative medicine. The true history
of mental health care includes contributors
from around the world during the last several thousand years,
although these progenitors are seldom if ever
mentioned in the textbooks for training mental health care
providers. This omission, however unintentional,
is inexcusable and has resulted in violations of intellectual
property rights and unnecessary misunderstanding.
Although Asia and Africa have been struggling to interface
traditional approaches with Western approaches
for a long time, this task has only recently emerged as a priority
in the United States (Incayawar, Wintrob, &
Bouchard, 2009).
The practice of psychotherapy is a political action with

sociopolitical consequences. Psychologists, counselors,
and scholars from Western cultures have presented a history of
protecting the status quo against change, as
perceived by people in minority cultures (i.e., racial minorities,
women, and those who perceive themselves as
disempowered by the majority). The lack of trust in people who
provide counseling services and the belief that
the status quo is being protected are documented in the
literature about “scientific racism” and European
American ethnocentrism (Pedersen, Draguns, Lonner, &
Trimble, 2008; D. W. Sue & Sue, 2003). Cultural
differences were explained by some through a genetic
deficiency model that promoted the superiority of
dominant European American cultures. The genetic deficiency
approach was matched to a cultural deficit
model that described minorities as deprived or disadvantaged by
their culture. Minorities were
underrepresented among professional counselors and therapists,
the topic of culture was trivialized in
professional communications, and minority views were
underrepresented in the research literature. Members
of the counseling profession were discredited among minority
client populations because they viewed
counseling as a tool to maintain the boundary differences
between those who had power and/or access to
resources and those who did not.
These cultural differences have resulted in racial
microaggressions in the everyday contacts between groups.
“Racial microaggressions are brief and commonplace daily
verbal, behavioral, or environmental indignities,
37

whether intentional or unintentional, that communicate hostile,
derogatory, or negative racial slights and
insults toward people of color” (D. W. Sue et al., 2007, p. 271).
Inclusive cultural empathy seeks to minimize
or eliminate racial microaggressions from multicultural contacts
by emphasizing the importance of context.
38
Alternative Indigenous Psychologies
There are already indigenous alternatives to individualistic
psychotherapy. China provides examples of
indigenous alternatives that de-emphasize individualism. Yang
(1995, 1999), Yang, Hwang, Pedersen, and
Daibo (2003), and Hwang (2006) conceptualized the Chinese
social orientation in two ways—first as a system
of social psychological interactions and second as a pattern of
inclinations or “natural” tendencies based on
past experience. This interaction between the person and the
environment is demonstrated in the tension
between isolated or independent tendencies and relational or
connected tendencies. Although the
individuated approach works well in some cultures to facilitate
measurement and treatment, for example, it
excludes valuable data from other cultures.
Santee (2007) described an integrative approach to
psychotherapy that bridges Chinese thought, evolutionary
theory, and stress management. This approach provides an
opportunity to view the culturally diverse perspectives of
Buddhism, Daoism, and Confucianism in a
context that will allow for the integration of these teachings

into Western counseling and
psychotherapy. This integration will, it is hoped, contribute to
resolving the problems facing
contemporary counseling and psychotherapy caused by its own
ethnocentric perspective and the
need to access cultural diversity. It is a move toward embracing
a new paradigm. It is a bamboo
bridge. (Santee, 2007, pp. 10–11)
The family orientation metaphor constitutes the core “building
block” of Chinese society, rather than the
isolated individual, as in Western cultures. “The Chinese people
tend to generalize or extend their familistic
experiences and habits acquired in the family to other groups so
that the latter may be regarded as quasi-
familial organizations. Chinese familism (or familistic
collectivism), as generalized to other social
organizations, may be named generalized familism or pan
familism” (Yang, 1995, p. 23). This family
perspective is significantly different from Western psychology’s
focus on the scientific study of individual
behavior.
Yang had the dream of an alternative to using inappropriate
Western psychology to understand balance in
Chinese society. He described the consequences of imposing
Western psychology on non-Western cultures:
What has been created via this highly Westernized research
activity is a highly Westernized social
science that is incompatible with the native cultures, peoples
and phenomena studied in non-
Western societies. The detrimental over-dominance of Western
social sciences in the development
of corresponding sciences in non-Western societies is the
outcome of a worldwide academic

hegemony of Western learning in at least the last hundred years.
(Yang, 1999, p. 182)
Liu and Liu (1999) pointed out that interconnectedness is a
difficult concept to pin down because it involves
39
synthesizing opposites, contradictions, paradox, and complex
patterns that resemble the dynamic, self-
regulating process of complexity theory: “In Eastern traditions
of scholarship, what is valued most is not truth.
In broad outline, the pursuit of objective knowledge is
subordinate to the quest for spiritual
interconnectedness” (p. 10).
Yang (1997) described his thinking as it evolved toward
understanding North American psychology as its own
kind of indigenous psychology, developing out of European
intellectual traditions but much influenced by
American society. He developed a list of “seven nos” that a
Chinese psychologist should not do so that his or
her research can become indigenous:
Not to habitually or uncritically adopt Western psychological
concepts, theories, and methods;
Not to overlook Western psychologists’ important experiences
in developing their concepts, theories,
and methods;
Not to reject useful indigenous concepts, theories, and methods
developed by other Chinese
psychologists;
Not to adopt any cross-cultural research strategy with a
Western-dominant imposed etic or pseudo-etic

approach . . . ;
Not to use concepts, variables, or units of analysis that are too
broad or abstract;
Not to think out research problems in terms of English or other
foreign languages; and
Not to conceptualise academic research in political terms, that
is, not to politicise research. (pp. 71–72)
Along with the “seven nos” Yang (1997) also suggested “10
yes” assertions to guide the psychologist in a more
positive direction:
To tolerate vague or ambiguous conditions and to suspend one’s
decisions as long as possible in dealing
with conceptual, theoretical, and methodological problems until
something indigenous emerges in his or
her phenomenological field;
To be a typical Chinese when functioning as a researcher
[letting Chinese ideas be reflected in the
research];
To take the psychological or behavioural phenomenon to be
studied and its concrete, specific setting
into careful consideration...;
To take its local, social, cultural, and historical contexts into
careful consideration whenever
conceptualizing a phenomenon and designing a study;
To give priority to the study of culturally unique psychological
and behavioural phenomena or
characteristics of the Chinese people;
To make it a rule to begin any research with a thorough
immersion into the natural, concrete details of
the phenomenon to be studied;
To investigate, if possible, both the specific content (or
structure) and the involved process (or
mechanism) of the phenomenon in any study;
To let research be based upon the Chinese intellectual tradition

rather than the Western intellectual
tradition;
40
To study not only the traditional aspects or elements of Chinese
psychological functioning but also the
modern ones...;
To study not only the psychological functioning of
contemporary, living Chinese but also that of the
ancient Chinese. (p. 72)
The consequences of extreme individualism in psychotherapy
are very dangerous to modern societies.
Westernized values that became popular in the 19th and 20th
centuries have sponsored destructive attitudes
and lifestyles; to prevent an ecological disaster, urgent changes
are needed in these values. Howard (2000, p.
515) identified nine “killer thoughts” based on Western
psychological values and assumptions: (a)
Consumption produces happiness; (b) we don’t need to think (or
worry) about the future; (c) short-term
rewards and punishments are more important than long-term
goals; (d) growth is good; (e) we should all get
as much of life’s limited resources as we can; (f) keeping the
price of energy low is a good thing; (g) if it ain’t
broke, don’t fix it; (h) we don’t need to change until scientific
proof is found; and (i) we will always find new
solutions in time to expand limited resources. The dangers of
exclusively imposing dominant-culture values
have led psychotherapists to better understand the values of
other, contrasting cultures.
One example of imposing Westernized, individualistic,

dominant-culture values is the primacy of “self-
interest.” Miller (1999) examined the “self-interest” motive and
the self-confirming role of assuming that “a
norm exists in Western cultures that specifies self-interest both
is and ought to be a powerful determinant of
behavior. This norm influences people’s actions and opinions as
well as the accounts they give for their actions
and opinions. In particular, it leads people to act and speak as
though they care more about their material self-
interest than they do” (p. 1053). The more powerful this norm
of self-interest is assumed to be, the more self-
fulfilling psychological evidence will be found to support that
premise.
41
Inclusive Cultural Empathy
The importance of “inclusion” comes from research in the hard
sciences, where quantum physics demonstrates
the importance of opposites, proving that something can be both
right and wrong, good and bad, true and
false at the same time through “both/and” thinking. The rules of
“exclusion” have depended on “either/or”
thinking, in which one alternative interpretation is entirely
excluded and the opposite is entirely accepted.
From this quantum perspective, empathy is both a pattern and a
process at the same time.
The intellectual construct of empathy developed in a context
that favored individualism and described the
connection of one individual to another individual. However,
globalization is changing that perspective. The
individuated self, which is rooted in individualism, is being

overtaken by a more familial concept of self, best
described by Clifford Geertz (1975):
The Western conception of the person as a bounded, unique,
more or less integrated motivational
and cognitive universe, a dynamic center of awareness, emotion,
judgment and action organized into
a distinctive whole and set contrastively both against other such
wholes and against a social and
natural background is, however incorrigible it may seem to us, a
rather peculiar idea within the
context of the world’s cultures. (p. 48)
In the more collectivist non-Western cultures, relationships are
defined inclusively to address not only the
individual but the many “culture teachers” of that individual in
a network of significant others. Being
empathetic in that indigenous cultural context requires a more
inclusive perspective than that found in the
typically more individualistic Western cultures. In identifying
the individual, the question should not be
“Where” do you come from? but rather “Who” do you come
from?
Inclusive cultural empathy is an alternative to the conventional
empathy concept applied to a culture-centered
perspective of counseling (Pedersen, Crethar, & Carlson, 2008).
Conventional empathy typically develops out
of similarities between two people. Inclusive cultural empathy
has two defining features: (1) Culture is defined
broadly to include culture teachers from the client’s
ethnographic (ethnicity and nationality), demographic
(age, gender, lifestyle broadly defined, residence), status
(social, educational, economic), and affiliation (formal
or informal) backgrounds; and (2) the empathetic counseling
relationship values the full range of differences

and similarities or positive and negative features as contributing
to the quality and meaningfulness of that
relationship in a dynamic balance. Inclusive cultural empathy
describes a dynamic perspective that balances
both similarities and differences at the same time and was
developed to nurture a deep comprehensive
understanding of the counseling relationship in its cultural
context. It goes beyond the exclusive interaction of
a counselor with a client to include the comprehensive network
of interrelationships with culture teachers in
both the client’s and the counselor’s cultural contexts.
The inclusive relationship is illustrated by the intrapersonal
cultural grid shown in Table 1.1. This visual
display shows how a person’s behavior is linked to culturally
learned expectations that justify the person’s
42
behavior and the cultural values on which those expectations ar e
based. Table 1.1 shows how each person’s
cultural context influences that person’s behavior through the
thousands of culture teachers from which each
person has learned how to respond appropriately in different
situations. To understand the person’s behavior,
one must first understand the cultural context.
Table 1.1 Intrapersonal Cultural Grid
Culture Teachers Behavior Expectation Value
Ethnographic (nationality, race/ethnicity, religion, language)
Demographic (age, gender, sexual orientation, physical

abilities)
Status (social, economic, political, educational)
Affiliation (formal, such as family or career; informal, such as
shared
ideas or values)
Empathy is constructed over a period of time during counseling
as the foundation of a strong and positive
working relationship. The conventional description of empathy
moves from a broadly defined context to the
individual person convergently, like an upside-down pyramid.
Inclusive cultural empathy moves from the
individual person toward inclusion of the divergent, broadly
defined cultural context in which that individual’s
many culture teachers live, like a right-side-up pyramid.
The conventional definition of empathy has emphasized
similarities as the basis of comembership in a one-
directional focus on similarities that does not include
differences (Ridley & Lingle, 1996; Ridley & Udipi,
2002). “The new construct of cultural empathy presented in
much of the literature appears to be
indistinguishable from generic empathy except that it is used in
multicultural contexts to achieve an
understanding of the client’s cultural experience” (Ridley &
Lingle, 1996, p. 30). Inclusive cultural empathy
goes beyond conventional empathy to understand accurately and
respond appropriately to the client’s
comprehensive cultural relationships to his or her culture
teachers, some of whom are similar to and others of
whom are different from the counselor.
By reframing the counseling relationship into multicultural
categories, it becomes possible for the counselor

and the client to accept the counseling relationship as it is—
ambiguous and complex—without first having to
change it toward the counselor’s own neatly organized self-
reference and exclusionary cultural perspective.
This complex and somewhat chaotic perspective is what
distinguishes inclusive cultural empathy from the
more conventional descriptions of empathy. We can best
manage the complexity of inclusive cultural empathy
in a comprehensive and inclusive framework. This
comprehensive and inclusive framework has been referred
to as multiculturalism.
The ultimate outcome of multicultural awareness, as Segall,
Dasen, Berry, and Poortinga (1990) suggested, is
a contextual understanding: “There may well come a time when
we will no longer speak of cross-cultural
43
psychology as such. The basic premise of this field—that to
understand human behavior, we must study it in
its sociocultural context—may become so widely accepted that
all psychology will be inherently cultural” (p.
352). During the last 20 years, multiculturalism has usually
become recognized as a powerful force, not just for
understanding “specific” groups but for understanding ourselves
and those with whom we work (D. W. Sue,
Ivey, & Pedersen, 1996).
44
Increasing Multicultural Awareness

Cultural patterns of thinking and acting were being prepared for
us even before we were born, to guide our
lives, to shape our decisions, and to put our lives in order. We
inherited these culturally learned assumptions
from our parents and teachers, who taught us the “rules” of life.
As we learned more about ourselves and
others, we learned that our own way of thinking was one of
many different ways. By that time, however, we
had come to believe that our way was the best of all possible
ways, and even when we found new or better
ways it was not always possible to change. We are more likely
to see the world through our own eyes and to
assume that others see the same world in the same way using a
“self-reference” criterion. As the world
becomes more obviously multicultural, this “one-size-fits-all”
perspective has become a problem.
During the last 20 years, multiculturalism has become a
powerful force in mental health services, not just for
understanding foreign-based nationality groups or ethnic
minority groups but for constructing accurate and
intentional counseling relationships generally. Multiculturalism
has gained the status of a generic component
of competence, complementing other competencies to explain
human behavior by highlighting the
importance of the cultural context. Culture is more complex
than these assumptions suggest. Imagine that
there are a thousand culture teachers sitting in your chair with
you and another thousand in your client’s chair,
collected over a lifetime from friends, enemies, relatives,
strangers, heroes, and heroines. That is the visual
image of culture in the multicultural counseling interview.
Psychotherapy in the not-so-far-away future promises to become
an inclusive science that routinely takes

cultural variables into account. In contrast, much of today’s
mainstream psychotherapy routinely neglects and
underestimates the power of cultural variables. Soon, there will
appear in connection with many psychological
theories and methods a series of questions:
Under what circumstances and in which culturally
circumscribed situations does a given
psychological theory or methodology provide valid explanations
for the origins and maintenance of
behavior? What are the cultural boundary conditions potentially
limiting the generalizability of
psychological theories and methodologies? Which psychological
phenomena are culturally robust in
character, and which phenomena appear only under specified
cultural conditions? (Gielen, 1994, p.
38)
The underlying principle of multicultural awareness is to
emphasize at the same time both the culture-specific
characteristics that differentiate and the culture-general
characteristics that unite. The inclusive
accommodation of both within-group differences and between-
groups differences is required for a
comprehensive understanding of each complicated cultural
context.
45
Comprehending Multicultural Knowledge
Accurate information, comprehensive documentation, and
verifiable evidence are important to the protection
of the health sciences as a reliable and valid resource.

Counseling Across Cultures: Essential Wisdom for Understanding Diverse Populations

Counseling Across Cultures: Essential Wisdom for Understanding Diverse Populations

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