Counselling in a Contemporary Context: Working Therapeutically with Identity, Difference and Diversity
In this piece of writing, I am going to define diversity, discuss how an understanding of difference and diversity will help the counsellor to respond to the client’s needs, as well as I will show my understanding of anti-discriminatory practice within the counselling environment. Additionally, I will consider cultural differences that might have a potential impact on the counsellor or the client during the therapy and will explore issues of similarity as well as differences. According to Queensborough Community College (2018), the concept of diversity includes respect and acceptance. Diversity means acknowledging that each person is unique and that it requires recognising our individual differences. There are different types of diversity, these include race, language, ethnicity, gender, age, sexual orientation, physical or mental abilities, religious beliefs, political beliefs or other ideologies (Community College 2018). It is felt that these differences could have an impact on the counsellor’s view of the client and build up barriers and challenges when forming a therapeutic relationship.
The Ethical Framework (2018) explains that the counsellors have a duty to demonstrate equality and respect diversity when interacting with their clients and uphold these qualities in relation to their colleagues (BACP 2018). For example, a client may be part of the transgender community and this may be difficult for some people to accept and/or understand (Fogarty and Zheng 2018). However, according to (Eckstrand and Ehrenfeld, 2018), in this situation the client must always be treated without bias, judgement, and always be approached as in a way that does not discriminate against them in any way. It is important to identify any issues that may affect a therapeutic relationship, as this will help to significantly improve the client- counsellor rapport. The Ethical Framework (2018) states “We will … endeavour to demonstrate equality, value diversity and ensure inclusion for all clients”. And “we will take the law concerning equality, diversity and inclusion and careful consideration and strive for a higher standard than the legal minimum” (BACP 2018). This shows that each counsellor is obliged to treat their clients equally and value their diversity.
Dr. Davis (2013) says that difference can be recognised in our personalities, experiences or even reactions to events. She emphasizes that is very important to recognise these differences when applying empathic understanding in the counselling therapy as otherwise it would be very easy to impose our own thoughts and feelings onto a client. For instance, if the client was expressing having experienced similar events to what the counsellor has experienced in the past, then this has the potential to cause a misunderstanding, or even create an unconscious bias. (Palmer and Milner, 2018) states that this type of situation often takes place, and it is believed that when this happens the counsellor must be able to identify this. Palmer and Milner, (2018) further states that the counsellor must then be able to reflect in a way that would reduce the chances of this event causing the counsellor to make judgements or assumptions based on their own experience. It has been considered that working with diverse clients who bring different ideas and/or values, the counsellor, in order to gain a greater understanding must be able to put aside their own preferences to obtain the ability to enter the client’s frame of reference (Palmer and Milner, 2018). Counselling skills and studies (2014), suggests that due to the counsellor’s similar beliefs or experiences they can appear in the way of seeing things from the client’s perspective, this is titled as ‘identification’. When ‘Identification’ takes place, this can often bring risks to a session in the form of making assumptions of the clients, or/and create an inability to identify with them because the two experiences are not the same (Counselling skills and studies 2014). The counsellor must show willingness and interest of the client to be able to create a relationship, so the client feels valued and heard on his own terms. It has been noticed that the therapist must accept certain behaviours but must reflect on what was stopping him to enter to the client’s world. In this situation, the practitioner must consider self-reflection or engage in the clinical supervision in which can explore own challenges.
Within the therapeutic relationship diversity and differences can create challenges that may present barriers. This can happen if the client chooses to talk about their attitudes or cultural references and the counsellor has a lack of knowledge or is unfamiliar with them. However, on some occasion diversity can benefit the therapy as the clients who speak with their therapist from a different background can find it beneficial as the therapist is unconnected to the issues that the client may bring in (Stevens 2018). Another challenge that may appear within the therapeutic relationship is the counsellor’s unconscious personal bias. This is likely to cause a personal assumption about the clients based on their characteristics, backgrounds or even their appearance. These assumptions are based on their own experiences or introjected values and can cause difficulties or even damage the therapeutic relationship. It is crucial to recognise what assumption or beliefs the therapist is holding regarding difference and diversity and be aware of how it can impact the interaction with the client (Stevens 2018).
To show understanding of difference and diversity I am going to illustrate how the counsellor can meet the clients’ needs in the following scenario.
Mahmuda is a female who grew up in a traditional Muslim household. She is wearing a garment called Niqab that covers her face but only her eyes are uncovered. The client expresses about life difficulties, however at times she appears silent and finds it difficult to engage in the therapy.
In this scenario I would find it very challenging to understand the client’s difficulties. I am aware that my lack of knowledge of this culture or background could create difficulty in my full understanding of the client. As a result of this the client could feel judged and misunderstood. According to S. Weatherheadng and A. Daiches in ‘Muslim views on mental health and psychotherapy’ (2009), Muslim population is still perceived negatively therefore their mental well-being is under threat. There is a significant evidence that the Muslim population who need therapeutic intervention still relies on praying, religious leaders, or family members, whereas the Western civilisation rely more on mental health/therapeutic professional intervention (Weatherheadng and Daiches 2009). This shows that the Muslim clients could be reluctant to build the necessary rapport, trust, and ability to engage with the therapist, especially if they uphold their own believes and continue to use religious ways as their only intervention. This could also influence the effectiveness of therapy. If the client’s face was covered but showing only eyes it could bring another difficulty in terms of understanding the client’s feelings. The facial expressions would not be visible and therefore the counsellor would feel prevented from seeing non-verbal communication that is also crucial in empathic understanding. Because of the cultural difference and the counsellors personal lack of knowledge about this situation, it could lead to assumptions, subsequently preventing the counsellor to acknowledge their true frame of reference. To overcome these barriers, it is felt that the counsellor should strive to educate themselves about Muslim traditions, faith, beliefs, and accept their unique values to gain a better and clearer understanding of their life. In terms of client-counsellor relationship I am led to believe that unconditional positive regard should be delivered, congruence and empathy should be present in order to build a therapeutic relationship regardless of my personal bias. Lees-Oakes (2018) states that if the therapist failed to understand their client culture and heritage then may ‘miss the client’ and not be able to fully enter their frame of reference. Moreover, if the counsellor failed to understand and appraise own heritage and culture then may stereotype and apply the label to the client. When building therapeutic relationship, it is important to ‘meet the client where they are’ and to achieve this is by being aware of own assumptions and biases, by understanding client’s over view and developing appropriate strategies and techniques (Lees-Oakes 2018).
It is paramount that a counsellor has high levels of self-awareness while practicing and engaging with the client. Counselling builds intelligence through self-awareness. As a form of intelligence, self-awareness in understanding of oneself including one’s own knowledge, attitude and opinions. The process of counselling essentially is a journey to self-discovery (Hutchinson, 2018). Self-awareness is about understanding and having insight into our own feelings and actions about the situation. For example, if female client who was previously abused by a male may appear fear full, irritated or tense in the presence of male counsellor and this could create a blockage to the therapeutic alliance. However, a totally different client could feel comfortable with a male counsellor due to previous positive relationships with other males.
McLead (2018), states that the counsellor must do everything to put aside own issues in life however, the counsellor may still experience different types of feelings towards the client, depending on the client’s chosen agenda. For example, as a result of potential triggers the counsellor can experience sense of hopelessness or feeling that something was being left unsaid. Also, the therapist can experience specific emotions such as anger, fear, boredom, sexual arousal or even sadness. Furthermore, the counsellor may feel physical reactions like being in pain, yawning or itchiness. Another reaction could be action tendencies like running away, holding client’s hand or moving closer (McLead 2018). McLean (2018) suggest that these reactions could be purely because something might be happening in counsellor’s life. For example, the counsellor could already come to the session feeling sad due to death of his family member. The lack of self-awareness could potentially damage therapeutic relationship with the client (Gumaer, 2008). For example, if during the session the counsellor shows lack of self-awareness it could affect the empathic understanding towards the client, the therapist could become ignorant or less attentive resulting the session being ineffective. Therefore, it is essential to become self-aware about own world view and to recognise how it can impact the client in counselling practice. Lees-Oakes (2018) suggests that one of the biggest differences in terms of Western and Eastern cultures is the concept of individual. Therefore, the Western culture puts values and individual achievement and success while Eastern cultures value collective decision making. Most cultures have visible and not so visible aspects. In terms of client-counsellor differences it is useful to relate to “cultural iceberg” which refers to the more obvious signs of difference (Lees-Oakes 2018). The most visible culture could be such as: food, dress, drama, celebrations, craft or language. However, only ten percent of these is visible and ninety percent of these is out of awareness because of the subtle nature of cultural interchange (Lees-Oakes 2018). Moreover, “it is the out of awareness area which is where the main emotion load and therefore exploration in therapy is carried out” (Lees-Oakes 2018). I am questioning as to how effective awareness is acquired, and how it can be improved in practice. I believe that self-awareness is something that we develop continuously throughout our life. This is due to Sully and Dallas (2010) statement that professionals are developing self-awareness throughout their life as it reflects on our work and enables as to learn from practice.
It is considered that when working with diverse clients it is important to maintain anti-discriminatory practice. This should include the counsellor’s self-reflection and ability to recognise own values, culture and ethnical identity as well as reflect what they mean to us and others around us (Winter, Feltham and Hanley, 2017). According to Thompson (2006) anti-discriminatory practice means that the therapist must treat their clients with respect, equality and must act for their best interest without personal bias and prejudice. Additionally, to prevent discrimination towards the clients the counsellors must not judge or stereotype and to be able to recognise an individual as person of worth regardless of their gender, race, religion, age, or abilities (Thompson 2006). Furthermore, in referring to anti-discriminatory practice in counselling field, the BACP Ethical Framework (2018), strongly relates to the Equality Act 2010. This law protects people from direct or indirect discrimination, harassment, and victimisation. Under the Equality Act, there are nine protected characteristics, such as: age, disability, gender reassignment, marriage and partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation (Equality and Human Rights Commission 2018). So within the counselling field the counsellors do not discriminate against anyone who maybe covered by the protected characteristic and try to make reasonable adjustments where necessary to be able ‘to meet the client where they are’ (Lees-Oakes 2018). According to BACP Equality and policy (2018), their members are committed to providing service that “embrace diversity and promotes equality within their workforce and their membership”. The aim is to support, treat fairly and remain free from discrimination. The Ethical Framework for Good Practice in Counselling and Psychotherapy (2018) says that “practitioners should not allow their professional relationships with clients to be prejudiced by any personal views they may hold about the lifestyle, gender, age, disability, race, sexual orientation, beliefs or culture”. Additionally, it also applies to their professional relationship with colleagues. Therefore, the organisations should be thoughtful when dealing with diverse clients.
To illustrate my understanding of anti-discriminatory practice I am going to use my personal example in my working environment.
During my shift I was working with a disabled, female patient who had hearing and speech difficulties. While I was interacting with her, I made sure that I spoke to her slowly enabling her to lip read and I used easy and simple terms to make sure she understood me. On another occasion I worked with a Black Catholic female patient who has been strictly praying three times a day. In this situation I made sure she can access her room and pray in her privacy, by doing so I showed to her my respect and understanding of her religious needs.
Relate ideas to therists – ‘Atkinson, helms and laungani’ – 100
Give brief summary of these theorists and what their therapies are.
How do they differ to each other?
How do they relate to counselling, equality and diversity?
Explore issues of similarities as well as differences – 100
Give an example of similarities and differences.
How can similarities and differences with the client affect the session.
How can it affect relationship?
How can it affect the counsellor?
Use positive and negative affects of similarities as well as differences?
Conclusion – 200
Summaries your assignment.
Bring it together and make sense of your findings.
Quuensborough Community College (2018), Definition for Diversity, New York online at http://www.qcc.cuny.edu/diversity/definition.html accessed on 27/10/2018
BACP (2018) Ethical Framework for the Counselling Professions, Lutterworth, Available at https://www.bacp.co.uk/events-and-resources/ethics-and-standards/ethical-framework-for-the-counselling-professions/ accessed on 27/10/208
Weatherhead, S. and Daiches, A. (2009). Muslim views on mental health and psychotherapy. Psychology and psychotherapy. 83. 75-89. 10.1348/147608309X467807. Available at https://www.researchgate.net/publication/26794589_Muslim_views_on_mental_health_and_psychotherapyaccessed on 08 November 2018
Fogarty, A. and Zheng, L. (2018). Gender ambiguity in the workplace. ABC-CLIO.
Eckstrand, K. and Ehrenfeld, J. (2016). Lesbian, Gay, Bisexual, and Transgender Healthcare. online Google Books. Available at: https://books.google.co.uk/books?id=6dGbCwAAQBAJ;printsec=frontcover;source=gbs_ge_summary_r;cad=0#v=onepage;q;f=false Accessed 8 Nov. 2018.
Palmer, S. and Milner, P. (2001). Counselling. The Bacp Counselling Reader Volume 2, SAGE
Hutchinson, D. (2015). The Essential Counsellor, Process skills and techniques. online Available at: https://books.google.co.uk/books?id=yFcXBAAAQBAJ;printsec=frontcover;dq=counselling+builds+intelligence+through+self+awareness.+as+a+form+of+intelligence,+self+awareness+in+understanding+of+oneself+including+one’s+own+knowledge&hl=en&sa=X&ved=0ahUKEwj_m-qNmMfeAhWiiKYKHZgTA0c4HhDoAQhfMAk#v=onepage&q&f=false Accessed 9 Nov. 2018.
McLead, J. (2018). Counselling Skills. online Google Books. Available at: https://books.google.co.uk/books?id=ezpFBgAAQBAJ&pg=PA61&dq=the+counsellor+may+experience+different+types+of+feelings+towards+the+client,&hl=en&sa=X&ved=0ahUKEwjc-p3PnsfeAhWBpiwKHdZ1AcUQ6AEIKDAA#v=onepage&q=the%20counsellor%20may%20experience%20different%20types%20of%20feelings%20towards%20the%20client%2C&f=false Accessed 9 Nov. 2018.
Gumaer, J. (2008). Counseling and Therapy for Children. online Available at: https://books.google.co.uk/books?id=ecVsAAAAMAAJ&q=lack+of+self-awareness+can+damage+therapeutic+relationship+in+counselling&dq=lack+of+self-awareness+can+damage+therapeutic+relationship+in+counselling&hl=en&sa=X&ved=0ahUKEwjbpsOPp8feAhXDlYsKHWrXCOQ4ChDoAQhaMAk Accessed 9 Nov. 2018.
Sully, P. and Dallas, J. (2010). Essential communication skills for nursing and midwifery. Edinburgh: Mosby/Elsevier.
Winter, L., Feltham, C. and Hanley, T. (2017). The SAGE Handbook of Counselling and Psychotherapy. Sage.
Thompson, N. (2006), Anti-Discriminatory Practice: Second Edition, Palgrave Macmillan.
Equality and Human Rights Commission (2018), Your rights under the Equality Act, online at https://www.equalityhumanrights.com/en/advice-and-guidance/your-rights-under-equality-act-2010 accessed on 14/11/2018
Stevens, E. (2018), How diversity impacts on the therapeutic relationship, Counselling Tutor,
Lees-Oakes, R (2018), The cultural iceberg, Counselling in diverse society, delivered 6 May 2018