Tag Archives: Multiculturalism & Diversity

Multiculturalism & Diversity

Fried chicken, watermelon, addiction and Appalachia

By Gerard Grigsby February 8, 2018

Hearing jokes about watermelon and grape Kool-Aid. Hearing someone talk about their “half-colored” nephew’s “nappy” hair. Being called “boy.” This is what I experienced over the year that I led an addictions process group in rural Appalachia.

After working in the area for almost four years, I had grown accustomed to hearing these types of comments, but the straw that broke the camel’s back was a response made in group after one member shared that she was dating outside of her race for the first time.

This particular group member said that she was no longer interested in “full-blooded white men.”

“Yeah, you like him now, but wait until he blacks your eye,” another group member commented.

We were gathered outside on a warm, sunny spring day, but a storm cloud of mixed emotions swept over me as I sat there in disbelief. As the leader of the group and the only person of color among a group of eight, I was at a total loss for words. I had no idea how to address what had been said, and I was too overwhelmed to convey exactly what I thought or felt in that moment.

I knew I felt invisible. I knew I felt voiceless. But without any guidance, I struggled to determine what my response should be or whether it would even be appropriate to share what I was feeling. Ultimately, I chose to remain silent and let the moment pass as if nothing had happened, but the weight of what had transpired lingered with me long after our group meeting had ended.

By the time I arrived home that evening, my initial shock and disbelief had transformed into anger and disappointment. I had been really fond of the group member who made the offensive comment, so it stung to hear him perpetuate such a harmful stereotype about people of color. It didn’t help that he had made this comment after I had worked so hard to be understanding and sensitive to the needs of the group, especially considering that many members perceived that their backgrounds made them targets for judgment and mistreatment by law enforcement, family, friends and even other counselors.

I had also worked very hard not to perpetuate stereotypes about people who are in recovery from addiction, and I had avoided repeating the derogatory language that is often used to describe the people of Appalachia. What made matters worse is that just months prior, there was general consensus among the group that no one liked being called a “junkie” or an “addict,” especially by someone who has never used drugs. Clearly, these members knew what it was like to feel marginalized, so how could they allow someone in the group to make such a racially insensitive comment and not challenge him?

I went to bed that night still upset about what had happened and woke up the next day feeling even angrier. In fact, I thought about that incident for several days. I consulted with my supervisor and processed what it was like for me to have led the group that day. I shared the details of the incident with my colleagues in a separate supervision group. I spent hours brainstorming different ways to confront the group about what had happened. I thought to myself, “Maybe I should compile a list of derogatory terms, share them with the group and ask members what they think about culturally insensitive language. Maybe I should stop being so careful with my words and ask members how they feel when they’re on the receiving end of microaggressions!”

These ideas came from a wounded place in me. I had worked hard to protect my group members, and it hurt having to accept that they had not been as protective of me. Thankfully, ongoing self-examination helped me set aside my own baggage and reminded me that it would be harmful and unethical to prioritize my own needs over those of the group.

Instead, I did some more processing and eventually decided it was less important for me to get retribution and more important for me to leave the members with greater insight than they had before joining the group. I wanted to do something that would be meaningful and impactful for everyone in the group, including myself.

The next week, I sat everyone down and implemented a new group rule: Please be mindful of the diversity represented within the group. Without my having to confront him directly, the group member who had made the offensive comment the week before knew immediately why I had made this request and, to his credit, apologized for what he had said. Although I did not take the opportunity to share with the group exactly how his words had impacted me, the act of advocating for myself and others in the group was healing enough.

In fact, addressing diversity issues that day served as a critical moment for the group and opened the door for continued discussions about race, culture, sexual orientation and other aspects of multiculturalism. Just a few weeks later, for example, a group member made a comment about fried chicken, to which I lightheartedly responded, “Is this another racist joke?” To my relief, the group laughed, and we went on to have a productive conversation about ethnicity, regional diversity and similarities between Appalachian culture and African American culture.

In hindsight, I don’t know if I used the best approach to address diversity issues in my group, but I can look back and appreciate how that first challenging experience (there were others afterward) helped to shape my counseling philosophy and improve my group counseling skills. It taught me when and how to address diversity issues in groups, and it served as a reminder that multicultural issues are always relevant, even in an addictions process group in rural Appalachia.


My recommended resources

If you have been in a situation similar to mine, or would simply like more guidance on addressing diversity issues in addiction counseling groups, check out the following books:

  • Group Exercises for Addiction Counseling by Geri Miller (2012)

Miller describes two activities that can be used to address diversity issues in addiction counseling groups. My favorite of the two, “Sharing Culture,” is a dynamic group activity that facilitates engagement, information sharing and processing. I won’t provide any spoilers if you haven’t read the book, but just know that this activity involves yarn and sounds like a lot of fun.

  • Group Work Experts Share Their Favorite Activities for the Prevention and Treatment of Substance Use Disorders, published by the Association for Specialists in Group Work (2015), and edited by Christine Bhat, Yegan Pillay and Priscilla Selvaraj

This book is full of engaging activities for anyone interested in group work, but one activity in particular may be useful for practitioners who want to address diversity issues in group. Submitted by Beverly Goodwin and Lorraine Guth, this activity requires group participants to identify what they know about their own ethnic, racial or cultural group, and then consider how different aspects of their identity impact their recovery.

My own spin on this activity would involve an initial discussion about drug culture — its norms, unspoken rules, daily practices and common beliefs of which people may be unaware. I see this as a helpful way to set the stage for a broader discussion about culture and diversity. I also think it would be a useful way to help group members process the fact that they are indeed giving up certain aspects of a valued cultural system when they decide to start their recovery. This context can help enrich subsequent discussions about culture, assimilation and acculturation as members discuss the process of letting go of drug culture and embracing aspects of other cultural systems that may be less harmful.




A version of this article was originally published in the December e-letter of the Association for Specialists in Group Work, a division of the American Counseling Association, and is used here with permission.



Gerard Grigsby is a fourth-year doctoral student in the counselor education and supervision program at Ohio University. He is licensed as a professional counselor in Ohio and has worked in college counseling and community mental health settings. Currently, he works at a substance use treatment clinic, where he has the privilege of serving and learning from individuals in recovery. Contact him at ggrigsby@hrs.org.




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Ethics, religion and diversity

By Gregory K. Moffatt February 5, 2018

Tears streamed down her face. Kaylah (not her real name) was a 21-year-old woman struggling with a romance in trouble. I’d seen it many times, even though I’d only been in the field for a few years at this point. My heart broke for Kaylah as I saw the same old story played out in the same old way — only the names and a few of the details were new.

Kaylah had been psychologically mistreated and her relationship was in serious trouble. Her partner demonstrated what social psychologists call the principle of least interest. This principle teaches that the person in any relationship — work, friendship, marriage — who has the least interest in maintaining it possesses the most power. My client’s partner treated her well on occasion but at other times humiliated her in front of others, exploded at her or ignored her for days on end. Kaylah tolerated these behaviors because she was desperate to maintain the relationship.

Kaylah’s partner’s emotions ran hot and cold. One day, they were talking about starting a family; the next, Kaylah’s partner threatened to leave, causing Kaylah to feel confused, hurt, angry and torn. Like most abused women, at times Kaylah felt surges of confidence that she should leave the relationship and never look back. Then, as if someone had flipped a switch, she was overwhelmed with love, hope and compassion for her relationship. In this phase, Kaylah made excuses for the pitiful way she was treated and assumed all the responsibility for their relationship troubles. It was classic battered woman syndrome.

What readers also need to know about Kaylah is that she was a lesbian. She was also a staff member at a church. Her lover, a member of the pastoral staff, was also Kaylah’s boss, which created a serious power issue (and a significant ethical issue too). For obvious reasons, the relationship was a carefully guarded secret. Kaylah had no one to talk to because her family wasn’t receptive to her lesbian lifestyle and she didn’t feel she could confide in her friends in the religious community. She also worried that if anyone found out, her partner would terminate the relationship — the thing Kaylah feared most in the world. Exposure might also mean that Kaylah could lose her job, her family and the few friends she had. She was totally isolated. What a mess.

One last thing that I need to tell readers: I am a person of religious faith, and until I met Kaylah, I hadn’t been forced to clarify the place for my religious beliefs in the counseling profession. That day, the decision I faced became crystal clear to me.

No room for debate

It was around the time that Kaylah entered my world that I taught my first college course overseas. As I was preparing to teach a marriage and family course in India, it dawned on me that our two cultures were very different. I worried that my knowledge would be so based in American culture that it wouldn’t translate well into Indian culture. But without denying our vast differences, my host reassured me. “Dr. Moffatt,” he said, “problems are problems.”

How right he was. Hurting relationships are the same regardless of culture, age, religion or sexual orientation.

In some ways, I can’t believe that equity for LGBTQ clients even remains a topic for debate. I remember when the AIDS epidemic first became public in the 1980s. Some people of religious faith actually stated that AIDS victims deserved the outcome as punishment for their lifestyle. I hope that even the most cold-hearted person today wouldn’t utter such nonsense. Even in those uncertain times when we didn’t know much about the disease, doctors served these men and women because it was their professional duty to do so, regardless of their personal opinions on homosexuality, drug use, multiple partners or other factors. Today, many nonprofit counseling agencies are run by faith-based agencies specifically for those who have HIV/AIDS. Thank goodness.

How, then, could there still be any possibility of debate in the 21st century over whether we should discriminate against our clients? Our concept of human rights as counselors is that all people deserve the same treatment, regardless of worldview, religion, gender, age or creed. Our modern view of equality has been evolving for decades, yet even counselors have not yet perfected it in practice. Just in the past decade or less, there have been several highly publicized court cases in which graduate students have refused to work with gay clients and suffered academic consequences because of their beliefs. These include Julea Ward in 2009 at Eastern Michigan University, Jennifer Keeton in 2010 at Augusta State University and Andrew Cash in 2014 at Missouri State University.

Supporters of these students lauded their bravery and commitment to their religion. Even though I am a person of faith, I cannot see why this type of irresponsibility to clients should be lauded. Interestingly, Christian tradition teaches that Jesus spent most of his time with the outcasts of his culture, not with the religious upper echelon, and he didn’t abandon people simply because they behaved in ways that were contrary to Jewish teachings. Gandhi and Mother Teresa also demonstrated a seeming lack of interest in religious pedigree. Instead, they helped the people who came to them.

Sadly, the three lawsuits from academia that I noted are just the ones that made the news. I suspect that many more therapists are practicing discrimination without the public becoming aware. “I’m not culturally competent to work with those issues” is a common argument that I hear among some in the profession to justify their referral of LGBTQ clients. In fact, the real reason is often a personal belief system rather than a question of competence. There is no way to tell how much of this type of referral or redirecting of client goals happens in our profession, but if my anecdotal experiences as a clinician, supervisor, professor and public figure in the field are any measure, the answer is a lot.

This clearly violates our ACA Code of Ethics. Under Standard A.4.b., we are clearly called to “seek training in areas in which [we] are at risk of imposing [our] values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.” Notice that it says seek training, not refer. In fact, Standard A.11.b. specifically prohibits referring solely on the basis of a conflict between the counselor’s values and the client’s values.

This culture war hit home for the American Counseling Association in 2016 when the Tennessee Legislature passed a bill that the state’s governor subsequently signed into law making it legal for counselors and therapists to discriminate against their clients if the client’s “goals, outcomes or behaviors … conflict with the sincerely held principles of the counselor or therapist.” This legislation clearly contradicted the ACA Code of Ethics. Consequently, ACA moved its planned 2017 annual conference from Nashville to San Francisco.

It should be noted that before we even get to the standards in the ACA Code of Ethics, our association’s mission statement directs that we exist to “promote respect for human dignity and diversity” through the profession. The key word here is not diversity but rather promote. We are actively to promote diversity, not actively run away from it.

A common base for truth

For any reader who thinks that I am not sensitive to the importance of religion, please bear with me. Religion does indeed matter, and many religions have clear teachings on a variety of subjects — sex, marriage, work, the roles of men and women — that are central to people’s faith and shouldn’t be ignored. But we must also recognize that many discriminatory traditions have their roots in religious teachings. Even in my short lifetime, I can remember a relative of mine excusing the discriminatory practices of his all-white church, saying, “God didn’t intend for the races to mix.” He then proceeded to use Bible verses to justify that belief. He made similar comments about mixed-race marriage, again justifying them weakly through religious teachings. Refusing to see clients based simply on sexual orientation is no different.

Some religious therapists have defended discriminatory practice by arguing that equating racism with clinical treatment of gay couples is comparing apples and oranges. The argument goes that if a counselor’s religious views teach that, for example, the heart of a couple’s problems is directly related to homosexuality — something the counselor’s religion teaches is inappropriate — then helping these clients maintain the very relationship that is causing their grief would be problematic if not unethical/immoral. I’ll address this argument momentarily. But, first, a brief tangent.

It would be disingenuous to say that counselors never force a worldview on a client. Of course we do. For example, one of the goals we almost always have for clients who are addicted is that they stop doing their drug of choice, even if they don’t want to stop. The difference between this worldview and that of the anti-gay worldview, however, is that this worldview is based on objective research, not moral code or religious teaching. Using methamphetamine destroys tooth enamel, leads to degenerative behaviors and can eventually kill the user. Alcohol abuse changes brain structure, destroys the liver and leads to degenerative lifestyle and potentially death, not to mention a host of other social ills.

As for a religious argument against homosexuality, there is no scientific evidence that being gay, transsexual, bisexual, etc., is clearly linked to any social or physical issue that is not also present among the heterosexual population. We must have a common base for “truth,” and that base is research, not religion.

Many years ago, a religious group, knowing I am a person of faith, asked me to do a seminar addressing why homosexuals would not be good parents. I refused because there is absolutely no evidence that one’s sexual orientation has anything to do with quality of parenting. It would be unethical to promote such a baseless argument. Academic integrity demands that as professional counselors, we pursue what we know. We must be driven by facts, not opinions and preferences.

Make a choice

Empathizing and working with a diverse population does not mean that a counselor must sacrifice her or his own position. We are free to think what we want, engage in our own religious practices and beliefs, and live our lives as we choose.

For many years, I’ve spent part of my year in the United States and part of the year in Chile, my second home. During this time, I have also traveled the world. Whether I’m in a clinic in India, the Philippines, Peru or Mexico, I still think like an American/Chilean. But when I’m in those varied cultures, I try to see the world through the eyes and culture of the people I encounter. I can easily do that without making any value statement about the culture itself, and even though I have personally adopted many customs and preferences from around the world, I have done so voluntarily. I would still be a competent counselor in those cultures if I hadn’t. My preferences are irrelevant when working in another country.

Our professional ethic simply means that we will not thrust our belief systems upon our clients any more than we would try to sell our clients a car, recruit them into a political party or manage their retirement accounts. What we cannot do is make choices that are at odds with wanting to work as a counselor, such as simultaneously wanting to function as a missionary who proselytizes clients into our personal belief system.

I occasionally work with individuals who have been mandated to treatment. Some of them have drug issues. I’ve heard all the arguments:

“Why is weed illegal? It’s a dumb law.”

“Who cares what I do in my own home?”

“Smoking weed doesn’t affect my job or my personal life, so why should I have to go to addiction counseling?”

My response is always the same. You can do anything you want — but all behaviors have consequences. If you want to smoke weed, go ahead. But if you don’t want to risk arrest, being fired from your job or kicked off your athletic team, don’t smoke weed. You can’t have it both ways.

To our profession, I make the same suggestion. If you are a pastor or priest, be a pastor or priest. Nobody is trying to stop you. But do not attempt to be a pastor while you are a counselor. If your religion teaches that you must proselytize in the workplace, then the counseling profession is not the best fit for you. There is nothing wrong with being a pastoral counselor in which your focus is pastoring, not counseling. But don’t pretend to be a counselor who is religious when, in fact, you want to function as a pastor who is also a counselor.

As counselors, our job is to help the hurting. We cannot — we must not — attempt to evaluate who we think is worthy of our help. Whether our clients are gay or lesbian, battered women or batterers, abused children or abusers, we don’t pick and choose who we help. Our ethical standards determine when we refer or step away, but our personal feelings — whether driven by religion, morals or anything else — have no role in our decision to help. Pain is pain. The pain of Kaylah’s relationship was no different than the pain from any other relationship. The fact that she was a lesbian was, in some ways, irrelevant.

Diversity includes people of faith

History hasn’t always been friendly toward people of faith. We hardly need to be reminded of the many wars and episodes of genocide that have been perpetrated against various religious groups throughout history. Even today in different places around the world, including the U.S., Christians, Jews, Muslims and others are persecuted for their faith. Television mogul Ted Turner brashly claimed in 1990 that Christianity was a “religion for losers.” These were thoughtless words from one who knew nothing of the religion. Jewish men, women and children are still isolated in many parts of the world. And I can’t imagine how difficult it must be to live as a Muslim in the U.S. Sadly, the words “Muslim” and “terrorist” are sometimes used interchangeably these days.

The field of psychology has not always been friendly to people of faith either. Sigmund Freud proposed that neurosis and religion were closely related and that religious people were weak and in need of a dominant father figure. In the 1950s, Alfred Kinsey despised religion, claiming it repressed “healthy sexual desires.” And as a graduate student, I was taught that we should never talk about religion in session, even if our clients brought it up, because it would only distract from more important issues. Really? Faith can be a central part of a person’s existence, influencing almost everything, from food, dress and marriage to job choice and child rearing. Yet I was taught that this was somehow unimportant and distracting.

About 20 years ago, I was presenting an ethics seminar for professional counselors. One of the case studies the seminar participants were supposed to discuss involved religion. The concise version of the question I posed was, “If your client was a person of religious faith, would it be acceptable to include that person’s religion in your therapeutic process?” Every single one of the 75 or so participants said no. Apparently, they had the same training I had.

I have personally witnessed bias within the counseling profession against people of faith. At professional conferences, I have heard comments in hallways and elevators openly disrespecting people of various religions. One clinician, wearing her conference name badge, rolled her eyes as the elevator door closed and said to another attendee, “Oh, God, this hotel is crawling with Christians. Heaven help us!” To which her friend snickered and nodded consent, as if Christians, Jews or Muslims were some sort of infestation.

At a past ACA annual conference, I attended a workshop on gay and lesbian issues. In the workshop, the leader subtly condescended to people of faith — something Derald Wing Sue calls microaggressions — and the audience openly jeered, laughed and mocked Christians in their public comments. No one said a word about the overtly biased, thoughtless and hurtful commentary. Although I certainly didn’t fear for my safety, I didn’t feel comfortable confronting this bigotry. And even though I agreed with the position presented by the session leader, I have never felt more discriminated against in my life.

The heckling I witnessed was the same thing that those in the LGBTQ community have rightly fought against in times past. It was the same behavior — only the target had changed. People of faith should be as welcome as members of any other group in a professional meeting.

I might also argue that people of religious faith can make outstanding counselors. Many religions teach the inherent value of all humans, creating a natural empathy among the religious for a hurting world. Although there are individuals who have used religion to pursue their own selfish agendas, there is no scientific evidence that people of faith are less intelligent, weaker or any less capable of working in the helping professions than are nonreligious individuals.


In a public presentation many years ago, Albert Ellis, a man known widely for his aggressive approach to his clients, littered his address with profanity. Visibly upset, several participants in the room eventually made an overtly public statement by storming out. The only remark Ellis made about it was this: “Counselors should never be upset with what people say.”

I have never forgotten those words. Whether or not Ellis was right, the message I took away was that, as counselors, we treat those who need help. In that regard, our clients’ words, sexual orientation, religion, age, gender, race, criminal history and socioeconomic status have no relevance. We help. That is what we do.

Many people in the counseling profession are also, in their personal lives, deeply committed to their faith. These counselors see clients daily without issue and function at the highest level of ethical conduct. But the few who feel they are called to change the profession, rather than to accept the profession as it is or to move on to another line of work, give us a black eye. Even worse, these counselors leave clients hurting — and perhaps discourage them from ever seeking help from another counselor again. It is always about the client.

Counselors using their religion as an excuse to refer clients or to force their ideas about sexuality upon their clients can deceive themselves into thinking they have ethical grounds for doing so. You don’t. Period. You must seek training to work through this issue (Standard A.4.b.) rather than perpetually referring LBGTQ clients.

As a footnote, I saw Kaylah in counseling off and on for a little over a year. During that time, her relationship went through various ups and downs. When we terminated, her daily functioning had improved significantly, but she was still nursing her seriously troubled relationship.

Months after termination, I happened across Kaylah in a shopping center. She was with her mother. Meeting clients on the street always makes me nervous, but when our eyes met from a distance, she beamed and ran toward me, towing her mother along by the hand.

Kaylah introduced me to her mother and, in turn, her mother’s face brightened. She stepped forward and hugged me tightly. When she stepped away, she had tears in her eyes. “I don’t know what all you did, but I know you saved my daughter,” she said. “Thank you for helping my baby.”

These were the most sincere and heartfelt words of gratitude I have ever received. I’m positive I did the right thing by my client, and I can’t imagine a world in which my religion would have allowed me to tell Kaylah to move along because I don’t work with clients who are gay.




Gregory K. Moffatt is a professor of counseling and human services at Point University in Georgia. He is a licensed professional counselor and certified professional counselor supervisor. Contact him at Greg.Moffatt@point.edu.

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Other pieces written by Gregory K. Moffatt, from the Counseling Today archives:




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Bringing Syrian hospitality into your counseling practice

By Shadin Atiyeh November 8, 2017

In a small village resting in a valley watched over by a medieval castle, the women made their morning rounds. At each house, they were met by the same ritual. A warm greeting with a kiss on each cheek, an invitation to sit and at least three rounds of offerings: sweets, coffee and fruit. This is an obligation, to express hospitality to guests, but the host treats it as an honor and a joy.

Between each offering, conversation flows about family members, friends and occurrences in the village. The host asks intentionally about each person in the guest’s life. Silences are reserved to hold sadness, grief or political sentiments better left unsaid. These silences are broken with “May God help,” or “baseeta,” translating literally to “simple,” but used to acknowledge the futility of talking about a topic and moving on to the next one.

The Arabic language is vast but vague. One word can carry many meanings, but translated without context, it can lose all meaning. Another example is “Yalla,” which the women will use to indicate that they are ready to leave and move on to the next visit. It can mean “let’s go,” and “hurry up” or “come on.” The goodbyes are drawn out, with invitations to stay longer, kisses and hugs. The guests invite the host to visit them next time.

These morning visits serve multiple purposes. There is no one in the village who will not have a visit from a neighbor, a friend or a family member each day. There is no household task that won’t have a helping hand. There is no meal that anyone in the village will eat alone. There is no newcomer who is not welcomed with multiple visits from each neighbor offering food and conversation. There is also no misstep, family argument or fashion mistake that does not get aired out with the dirty laundry in rooftop conversations. In English, there are many words for aloneness, and each word can have either positive or negative connotations (e.g., solitude and loneliness). In Arabic, “wahida” has a mostly negative connotation: sadness, loneliness, pity.

The values of hospitality, community and honor are central to Syrian and many Middle Eastern cultures. Growing up as an American of Syrian Arab descent, my father told us one story to teach us true hospitality. This story did not involve a fellow Arab but rather a Jewish man who helped my father when he arrived in the United States from Syria at the age of 18. This Jewish business owner gave my father his first job in the United States and supported him in his first years.

When I visited Syria for the first time with my father, I experienced the hospitality and community that he knew. These values can be hard to find in the United States — a primarily individualistic culture where privacy is paramount and the belief that we must make it on our own is prominent. I can imagine the culture shock when my father came to the United States and possibly went a few days without a knock on the door from a neighbor. I felt a similar shock in Syria. I remember craving some privacy or solitude in which to think and read, some freedom from feeling scrutinized.


Bridging cultural boundaries

As a licensed professional counselor and approved clinical supervisor working with refugee populations, I try to hold on to an empathy for how culture shock feels and to encourage that empathy among my supervisees. I have an appreciation for my father’s story because I currently work at a Jewish agency expressing Jewish values by resettling Middle Eastern refugees. I have a firsthand experience of the power of this work to bridge cultural boundaries.

As the Syrian refugee crisis continues, refugees are forced to flee their communities and are placed in third countries for resettlement when there is no opportunity to return home. In the United States, a network of nonprofit agencies is responsible for meeting families at the airport, securing housing and providing basic services and cultural orientation. I have learned that we can accomplish these steps either by checking off the boxes or by approaching these refugee families with the same spirit of hospitality and welcoming that they most likely would afford to us. Doing so demonstrates respect and honor and eases the culture shock of being in a new country.

How could you incorporate hospitality into your counseling practice to make it more welcoming for those of Middle Eastern descent? You can follow some rituals that might help to evoke a sense of respect and suggest that your practice is a place to sit and talk.

Many therapists in the United States put effort and thought into how the room is set up. This traditionally involves a private and quiet setting, dim lighting, plants and the therapist’s chair facing a couch. You might have a table with drinks available, but it is important to insist that these clients partake because they would not think it appropriate to take a drink on their own or accept a drink on the first offer. Going through the ritual of making and pouring coffee for your client further demonstrates care and respect. Having a candy dish or sweets tray can also be useful, but it is important to hold the dish and offer it to these clients.

Giving gifts acknowledges the value of relationships to these clients, so you might consider giving small gifts at the first and last sessions. These gifts might be cards, representational items, journals, bookmarks or books. These gifts can serve a therapeutic purpose.

Artwork on the walls can include Arabic writing, such as the words “Ahlwan wa Sahlan,” meaning “Welcome and Health.” Some therapists have their name in Arabic next to the English writing on their doors. If your client speaks English as a second language, make an effort to learn some words that can communicate empathy for the difficulty of learning a new language and having an accent. One of my favorite moments with a client was when my position as the all-knowing authority was shattered by my broken attempts to speak French.

Be careful not to assume what language your clients speak. Instead, ask. Iran, Afghanistan and Somalia, for example, are not Arab countries and speak languages other than Arabic. There are also different ethnic groups such as the Kurds, Armenians, Jews and Chaldeans within Arab countries who may not speak Arabic as their first language.

Don’t expect your client to teach you about their culture. Obtain supervision and consultation and read from credible sources. Hisham Matar’s In the Country of Men is a novel that offers raw insight into the experience of a child growing up in Libya and being forced to leave. Bint Arab: Arab and Arab American Women in the United States, by Evelyn Shakir, portrays the diversity of Arab American cultures and the dissonance women of Arab descent experience living in the United States.

Poetry is another window into cultures and is a highly revered art in Arab traditions. Some famous Arab and Arab American poets include Nizar Qabbani, Adonis, Khalil Gibran and Maram al-Massri. These poems might also be therapeutic tools.

The Arabic language is also ornate, formal and elaborate. It is not enough to say, “Welcome”; you should say “Two welcomes.” When someone says, “Good morning,” the response should be more extravagant, such as “Morning of light.”

There are many sayings and poems that could hold the extreme sadness, loss and loneliness attached to leaving one’s country, home and community. Qabbani wrote: “My son lays down his pens, his crayon box in front of me and asks me to draw a homeland for him. The brush trembles in my hands and I sink, weeping.” My clients might spend a lot of time talking about how loss of homeland has affected their children, parents and other family members. I honor my clients’ positions in their families and allow them to discuss these other people in session because these family members might be extensions of self.

Your clients are the experts on their experiences of their culture and their perspectives on it. Many clients from racial or ethnic minorities might be walking into your office with the same questions: Will the therapist understand my culture? Will the therapist respect my culture?

As the counselor, you have the power to initiate a conversation about these unspoken questions, make these concerns explicit and address them. Respect and acknowledge differences while also connecting on commonalities such as the feelings of loss, guilt and shame.

Counselors working with this population must also acknowledge the political and social climate in which these refugees are entering the United States. Experiences and fears of discrimination and prejudice have contributed to increased anxiety, depression and traumatic stress among Arab Americans in the United States. Adding clients’ past traumatic experiences to these experiences can lead many to isolate themselves further.

Therapists in the United States inundated with negative images of the Middle East might be at risk of holding unexamined negative stereotypes and beliefs about Middle Eastern people and their cultures. The therapeutic space can become a place of risk for further harming vulnerable clients, or it can provide an opportunity to give clients a chance to experience understanding and support.

In bringing a spirit of Syrian hospitality into my work as a counselor, I am able to communicate a warmth and welcoming to my clients. As my clients walk a tightrope over an ocean — behind them loss and in front of them both danger and opportunity — I hope the therapeutic space offers rest and reflection. A good host is usually invited as a guest. I attempt to be invited as a guest into my clients’ lives so that I can work with them to build bridges over those oceans.


“Light is more important than the lantern. The poem more important than the notebook.” — Nizar Qabbani



Shadin Atiyeh is a master’s-level licensed professional counselor in Michigan, national certified counselor and approved clinical supervisor. She is currently a doctoral student in counselor education and supervision and a department manager within a refugee resettlement and social services agency. She has five years of experience providing clinical services, case management and employment services with vulnerable populations, including refugees and other immigrants, survivors of domestic violence and sexual assault, and families experiencing homelessness. She also serves as a clinical supervision for counseling interns and prelicensure counselors. Contact her at shadin.atiyeh@waldenu.edu.




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Making the counseling profession more diverse

Compiled by Laurie Meyers October 25, 2017

For many years, white men were presented as the face of the counseling profession and largely dictated its focus and direction. The American Counseling Association (originally known as the American Personnel and Guidance Association) was founded in 1952. Nineteen of its first 20 presidents — many of whom went on to become giants in the field — were white men. Given American society during that period, the lack of diversity at the highest levels of leadership wasn’t unusual.

When Thelma Daley was elected in the mid-1970s, she became the association’s first African American president (and only its third female president). Although women began ascending to ACA’s top leadership position on a fairly regular basis over the next two decades, it wasn’t until 1993-1994 that the association elected its second person of color as president — Beverly O’Bryant.

From those modest roots, there is little argument that the profession has grown abundantly in the emphasis it places on multicultural understanding in the practice of counseling. Conference programming, book titles and journal articles, continuing education offerings and other resources regularly address issues of multiculturalism. Updated and comprehensive Multicultural Counseling and Social Justice Counseling Competencies provide professional counselors guidance on working with diverse populations. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) has made social and cultural diversity a core curricular area in the counselor education programs it accredits.

Even as the profession stresses the need for counselors to continually strive for multicultural competence, however, there is a recognition by many that the profession remains challenged in its ability to diversify its professional ranks. Many feel that the counseling profession is still largely dominated by white culture. Others point out that in many areas of the country, clients struggle to find counselors with whom they can identify culturally.

Given these circumstances, Counseling Today asked a number of ACA members who study diversity to share their thoughts — in their own words — on a complex issue: What needs to happen to make the counseling profession more diverse?



Thelma Daley

ACA fellow Thelma Daley, the first African American president of both the American Counseling Association and the American School Counselor Association

Historically, the counseling profession has not been multicultural. In fact, many are still trying to define multiculturalism. When I became the first African American president of the American School Counselor Association (ASCA) and, a few years later [1975-1976], the first African American president of the American Counseling Association, there were less than 50 persons of color at the conventions. Additionally, not many women were holding key leadership roles. It is amazing to think that the governing board during my presidential term consisted of one white woman, and the remainder were white men, mainly from Southern universities.

Peruse the growth of the many divisions [in ACA], and one gets a picture that counselors from many aspects of life have fought for and are given recognition in an inviting place for expression, growth and development. However, the struggle continues.

We have come a long way, but the door has only been cracked. Institutional prejudice has not gone away. In fact, it has been awakened from its soporific state. More than ever, the profession is needed, and all racial/ethnic groups should have access to high-level counseling professionals with whom they can relate freely.

There is a need to survey the hiring practices, the working conditions and the pay, which might be repelling forces for those who might want to consider the profession.

People gravitate to where they see others who are like them. A stumbling block might be finding the means to recruit cadres of underrepresented populations and offering them the training and work sites with supervision, similar to AmeriCorps. A bold, creative step is needed. As we seek new populations, remember that we add and do not discard. Build upon the progress we have made. Whatever is done should involve a broad spectrum of professionals and citizens. The concern is beyond just counselor educators. Even the terminology used by the helping professions may rebuff some cultures.

In spite of the perceived deficiency, the association and the overall profession have truly advanced in making commendable strides toward inclusion and diversity. A laudatory foundation is in place that should make the forward thrust possible and achievable. It is my belief that most active members are open and ready to move beyond the status quo and will seek to enjoy and be enhanced by the amalgamation of rich new cultures of this wonderful world. Let us take a giant step and never shy away from expanding the realms of diversity within this great profession.


Selma de Leon-Yznaga

Selma de Leon-Yznaga, past president of Counselors for Social Justice, founder of Texas Counselors for Social Justice, associate professor of counselor education at the University of Texas Rio Grande Valley and an expert on ethnic identity development and student success, issues surrounding Latina/o immigration, acculturation distress and racial discrimination

Confirming the representation of diversity among counseling students and professionals continues to be a challenge, despite our professed commitment to multiculturalism. CACREP reports some demographics in its yearly Vital Statistics Report, although this data is collected inconsistently by counselor education programs, especially for applicants not accepted and students who don’t complete the program. In addition, ethnicity is the only attribute assessed systematically, with little data available on students with disabilities, sexual orientation or transgender identification. If we aren’t even asking about and reporting it, it can’t be a surprise that students and professionals of ethnic and cultural diversity continue to be underrepresented in our programs and profession.

CACREP reported a slight increase from 2012 to 2015 in master’s-level enrollment by aggregated non-Caucasian students (38.81 percent and 39.45 percent, respectively). However, the graduation rate for total students enrolled in CACREP master’s programs was only 30 percent in 2015. It’s not clear how many of the 70 percent who didn’t complete [their programs] were ethnic minorities.

Enrollment of doctoral students in our programs narrows the diversity gap further: 41 percent and 46 percent of students in 2012 and 2015 were non-Caucasian. Again, the completion rate is disappointing: 16 percent (2012) and 18 percent (2015). Unfortunately, CACREP doesn’t provide disaggregated data by ethnicity for graduates; we have no way of knowing which share of noncompleters ethnic minority students comprise.

Faculty diversity rates in counselor education programs suggest that ethnic minorities in doctoral programs are not graduating at the rate of enrollment. Only 25.6 percent of the [counselor education and supervision] faculty reporting to CACREP in 2015 were ethnic minorities. With only one quarter of our faculty members reflecting the demographics of almost half of our master’s and doctoral students, it might be that students of color don’t feel a sense of belongingness or acceptance.

The counseling profession was developed by and for the American dominant culture (male, white, heterosexual, cisgender, nondisabled). In our counselor education programs, we continue to disseminate theories written for and normed on the dominant culture, despite rapidly changing demographics. More contemporary constructivist and feminist theories tend to be covered in courses as ancillary, not major, theories.

Until we can make counseling meaningful and practical for clients of all demographics,
the marketability of counselors will be low, and we will continue to attract students who represent the dominant cultural group, who in turn will attract clients from the dominant cultural group.

Until we can make counseling a service that is accessible to and valuable for culturally diverse communities, I think we will continue to struggle to attract and graduate diverse students. Until we attract and graduate diverse students, we aren’t likely to develop counseling theory and practice that meet the needs of diverse community members, and so the cycle is perpetuated.

Few people of color have had personal experiences with counseling, other than school counseling. It’s a service that is out of reach for many people of color. Priorities for ethnic minorities who tend to be overrepresented in poverty rates do not include one-on-one mental health counseling. A relatively long-term investment in time and money, counseling does not have an immediate or discernible return for the family. Without the experience or valuing of counseling, it’s hard to attract or interest potential students.

Living and working in one of the nation’s poorest, majority Latinx communities has taught me that counseling services are of little value to those who cannot afford them. Counseling as we currently conceptualize and provide it is a luxury that most in my community can only take advantage of through free social or school-based services. I don’t think we’re that different from other communities with high concentrations of ethnic minorities.

Many of the students in our geographical area are first-generation Americans and college students, and making the significant investment in college requires a commensurate return, whether it be financial or prestigious. Most of our families want their students to major in a discipline that they recognize and value, and that will “pay off” in the long run. The unfamiliarity with counseling is a big obstacle for potential students who usually have to get buy-in from the whole family to make the sacrifices necessary in graduate school.

Socially, a large-scale destigmatization media campaign aimed at ethnic and cultural minorities would educate communities in the process and benefits of mental health counseling. I recall a commercial sponsored by Johnson & Johnson for the nursing profession that ran during prime time on television and gave the public a sense of the multifaceted role of nurses. Making the public aware of our emphasis on wellness, client strengths and a here-and-now orientation might increase our practical value and attractiveness. A rise in public demand and job opportunities in diverse communities would most likely increase interest in counseling program enrollment for students of color and cultural diversity.


Carlos Hipolito-Delgado

Carlos Hipolito-Delgado, former president of the Association for Multicultural Counseling and Development and associate professor of counseling at UC Denver; his research focuses on the ethnic identity development of Chicanas/os and Latinas/os, the effects of internalized racism, improving the cultural competence of counselors, and the sociopolitical development of students of color

A colleague of mine at University of Colorado (CU) Denver, Diane Estrada, and I were talking about the lack of ethnic diversity in our graduate student body. At the time, we were a faculty of eight, and four of us identified as people of color. Counselor education at CU Denver prides itself on our focus on issues of diversity and social justice. Despite all of this, less than 15 percent of our students identified with a community of color. Dr. Estrada, our graduate assistant, Marina Garcia, and I ran a study [“Counselor education in technicolor: Recruiting graduate students of color,” published in the Interamerican Journal of Psychology] investigating factors that influenced graduate students of color to pursue counselor education.

Over the span of a year and a half, we were able to interview 19 graduate students of color from across the U.S. These students were enrolled in master’s-level and doctoral programs. They also represented private, public and for-profit universities.

There were two primary factors that seemed to influence our participants’ decisions to become counselors: exposure to the counseling profession and commitment to diversity and social justice. Graduate students of color who had been involved with counseling, had family who worked in the helping professions and who themselves worked in related fields described how these experiences pushed them to explore counseling as a career option. What is more, these students also mentioned how they benefited from encouragement from family members and professional mentors.

In terms of commitment to diversity and social justice, participants wanted to work in a career field that would allow them to serve marginalized communities. Further, they were attracted to counselor education programs that demonstrated a commitment to issues of multiculturalism and social justice.

If, as a profession, we are committed to diversifying our ranks, we must do a better job of reaching out to ethnic minority communities. We must educate these communities about the value of mental health, the role counselors play in promoting mental health and how counseling can be a tool for facilitating community empowerment. I would recommend that we target communities of color by creating career education programs to teach youth about counseling, encourage counselors to serve as mentors for youth of color, develop internship opportunities at the high school and college levels to give students of color experience in counseling settings and look to expand our undergraduate course offerings to attract more students of color.

Additionally, if we can continue to show how counselors promote social justice for ethnically diverse communities, we will attract more students. ACA has done a superb job of this this year by issuing statements supporting DACA (Deferred Action for Childhood Arrivals program) and denouncing religious and ethnic discrimination. However, it is also time for counselor education programs to demonstrate this commitment. This goes beyond a diversity statement. It entails having faculty of color in leadership positions, infusing diversity and social justice into all facets of their programs and providing internship experiences with ethnically diverse populations.


Cirecie A. West-Olatunji

Cirecie A. West-Olatunji, past president of ACA and AMCD, associate professor at Xavier University of Louisiana and director of the Center for Traumatic Stress Research; she has initiated several clinical research projects that focus on culture-centered community collaborations designed to address issues rooted in systemic oppression, such as transgenerational trauma and traumatic stress

There are several possible explanations for this phenomenon [a lack of greater diversity in the counseling profession]. Scholars have documented the implicit bias in academia wherein entering faculty of color and women experience marginalization and bias related to their teaching styles and research agendas. Thus, even when individuals are chosen for faculty positions, they often do not get tenure and leave.

Even more concerning, many doctoral students of color are not groomed to enter the professoriate. As graduate students, they are not selected to participate in research projects with faculty mentors to gain opportunities to apply their classroom knowledge about research in grant writing, dissemination at conferences and in academic journals. Thus, they often do not have competitive CVs [curricula vitae] or noteworthy letters of recommendation from faculty when applying for academic positions.

At the master’s level, students of color are less likely to be mentored by faculty to prepare them for doctoral studies. They are frequently not regarded as doctoral material. Instead, they are considered to lack intellectual capacity or sufficient curiosity.

The Association for Multicultural Counseling and Development (AMCD) has been at the forefront of this issue since the late 1970s. After several heated Governing Council meetings, the Association for Non-White Concerns was formed to highlight the issues of non-white counselors in the association. Later, the name was changed to broaden the scope of the organization. However, this division within ACA has continually advanced discussion and social action regarding the marginalization of groups of individuals within the profession. Most notably, AMCD scholars drafted the Multicultural Counseling Competencies that are widely used today within and beyond mental health disciplines.

Even today, AMCD serves as a haven for ACA members who seek support, advice, validation and increased competence. Most recently, AMCD sponsored the Courageous Conversations panel series that allowed women and men to talk about their unique experiences in counselor education. This was such a successful endeavor that a national webinar series followed. In these sessions, panelists and attendees shared their stories of distress and resilience in the academy as graduate students took notes on what to do and what not to do.

Yes, progress has been made. Despite the need for increased multicultural and social justice competence among white faculty and administrators, in comparison with our sister organizations, ACA has been quite active in pursuing multicultural ideals. First, our CACREP Standards hold counseling programs accountable for providing multicultural training throughout the curriculum. This is not a suggestion as is the case with other disciplines; it is a requirement. Second, for NBCC (National Board for Certified Counselors) accreditation, individuals must demonstrate multicultural knowledge on certification examinations. NBCC has also funded a Minority Fellows Program that has a strong mentoring component to it. Third, [ACA CEO] Rich Yep has established a climate of multicultural acceptance within the culture of the organization. Thus, in the execution of the membership’s wishes, the staff is held accountable for multicultural considerations. This is key and vital to a living, dynamic commitment to multiculturalism. Most of the ACA membership may not be aware how diverse the ACA staff is.

Areas to work on are: 1) increasing the percentage of faculty of color, 2) augmenting the percentage of doctoral candidates prepared to assume faculty positions, 3) ensuring that graduate students and early career professionals of color are mentored appropriately to afford them the opportunity to engage in leadership and research experiences, and 4) connecting with minority-serving institutions (historically black colleges/universities, Hispanic-serving institutions and tribal colleges) to access larger populations of graduate students and faculty of color.

The major obstacle to increasing multiculturalism in counseling is structural bias. Until we are able to assist individuals in unpacking their implicit biases toward socially marginalized individuals, it will be difficult to make any significant headway in advancing multicultural competence or expanding opportunities for women and individuals of color in counselor education. This refers to ideological as well as interpersonal differences. Thus, even white faculty who advance critical concepts such as social justice in counseling are likely to be marginalized. In essence, our ideal goal is to flip the switch and establish diversity as the mainstream normative value and marginalize cultural hegemony (i.e., Eurocentrism, including white masculinity as dominant) within our profession. It’s a tall order but possible within what’s left of even my lifetime.


Manivong Ratts

Manivong Ratts, past president of Counselors for Social Justice, chair of the committee that developed the Multicultural and Social Justice Counseling Competencies and associate professor of counseling at Seattle University, where he runs the Social Justice Research Lab

To understand the lack of diversity in the counseling profession, one must examine the root of the problem. Higher education, and counselor education by extension, has largely been a predominately white institution. As such, institutions and programs continue to use admission criteria that advantage applicants from privileged groups over applicants from marginalized groups.

For example, graduate programs continue to look favorably at applicants who have volunteer experience. However, being able to volunteer is a luxury that is not always available to applicants who live in poverty. Such applicants sometimes work multiple jobs and, therefore, may not have extra time to volunteer. Many graduate counseling programs continue to also use the Graduate Record Examination (GRE) as admission criteria. Yet, research has shown the cultural bias inherent in GRE scores. Most in the professoriate in counseling are also white. There is a tendency for people to admit applicants who look like them because such applicants make them feel comfortable.

Counselor education programs continue to use admission protocols that fail to reach communities of color. For example, many counselor education programs fail to recruit in communities where people of color reside. It is much easier for faculty to hold admissions fairs on university campuses instead of in the communities where applicants of color reside. In addition, counselor educators, many of whom are white, continue to lack understanding that recruiting applicants of color into their programs is just part of the challenge. Programs must focus on retention as much as they focus on recruitment. This requires programs to evaluate whether current structures that are in place favor white students over students of color. For example, teaching students of color who intend to return to their communities counseling theories that are individualistic in nature may lead such students to question the relevance of their training.

Many counselor education programs [also] fail to focus on the unique training needs of students of color. Programs must understand how being a member of a marginalized group shapes the counselor experience differently for counselors of color. Being able to address this issue will better prepare counselors of color for their work.


Shabnam Etemadi Brady

Shabnam Etemadi Brady, a doctoral counseling psychology student at Tennessee State University in Nashville who studies and works with immigrants and is herself an immigrant to the United States

From a master’s program in clinical mental health counseling to a doctoral program in counseling psychology, I have been the token Middle Eastern, immigrant, ethnic minority woman surrounded by mostly Caucasian peers and colleagues. One of the greatest barriers I faced in applying to and considering graduate programs in counseling and psychology was that of the GRE. Here I was again post-ACT/SAT experiences, attempting to take another standardized exam that was not created for me; rather, it was standardized on a majority group unrepresentative of me and my background. Thankfully, my grade point average and work ethic supported my competency as a student. However, this process turned me away from considering many master’s and Ph.D. programs. This can be a point for programs to consider when desiring to recruit students of diverse backgrounds, especially bilingual immigrants. The GRE is not always a marker of our success. Inclusivity in application criteria is welcoming.

[Another barrier I] faced and continue to face is the lack of accessibility to the population that I am now specializing in — immigrant and refugee communities. I had to become self-driven in this regard with both graduate programs because they did not have partnerships with agencies serving such diverse populations. Programs can partner with local agencies to expand practicum experiences for students interested in working with diverse populations.

Both of my programs are very welcoming to diversity. They seemed open and excited about my experiences as early as the interview. Additionally, both programs have diverse faculty as part of the program, which aligns with this value and interest. One program had only one diverse faculty member, and she soon became my mentor. My current program has two diverse faculty members who are knowledgeable and in support of multicultural work in mental health.

The greatest support I have received in both programs has been constant encouragement when I have initiated practicum positions with agencies serving the population I am interested in helping. Both programs allowed for me to engage in this clinical work as well as in research concerning immigrants and refugees. They have allowed me to share my experiences in classes, workshops and conferences. Faculty at both programs have vocalized their satisfaction and delight with my work. Thus, their appreciation of work concerning immigrants and refugees in mental health has encouraged my continued efforts in the field.

My cohort in my master’s program consisted mostly of Caucasian students [along] with myself and one African American student. The program has made efforts to increase both diversity in faculty and in students with recruitment strategies. My cohort in my doctoral program consists mostly of Caucasian students, me and three African American students.

I am often surprised to be the only immigrant and the only Middle Eastern student. When I learn about organizations in mental health for Middle Eastern students, I quickly run to join. I often feel isolated, with few people who understand my pursuit of higher education from a collectivist culture. I am a first-generation college and Ph.D. student. Most of my family is thrilled and in complete support of my graduate studies, but they do not always understand what the work entails. I find myself overwhelmed negotiating cultural values (collectivist and individualist) in achieving my dream.

For both of my programs, I have been the expert in immigrant and refugee topics because my programs have been cohort models and not adviser-advisee models (i.e., being matched to faculty who are experts on a student’s research interests). In classroom dialogues, I find myself “teaching” other students about mental health work with immigrants and refugees. Multicultural curriculum needs to be more inclusive of these groups for students and faculty to gain such critical training in mental health fields.

A fundamental resource that I receive as a first-generation college and Ph.D. student is financial support. Both of my programs have helped me secure a graduate assistant position that has partially funded my graduate education. Many immigrant students may endure hardships due to the socioeconomic implications of immigration. Graduate assistant funding can be a form of support and motivation for students from this group to enroll and to succeed in the field of counseling.

Individual counselors and programs can do the following in support and in encouragement of diversity for our field:

  • Model multicultural competency in your work and demeanor. Ask students/clients how to appropriately pronounce their name(s), what they prefer to be called, and pronounce these correctly. Ask them their preferred pronoun too.
  • Provide an inviting environment. Display culturally inviting photos of those from different cultures in mental health, a globe or greetings in different languages.
  • Hear students/clients and support them. I’ve been OK with being the token Middle Eastern, immigrant ethnic minority woman because both of my programs listened to me and supported me. They have shown me that they care about my success through interactions such as meetings, mentoring and resource initiatives for me.
  • Do not generalize; rather, individualize. Ask diverse students/clients about their experiences without exploiting them for your learning process. Get to know your students. Their stories have value and are often the reason that they are in mental health.
  • Similar to a therapeutic relationship, promote genuineness, authenticity and a safe space for diverse students to enroll in your program or to succeed. Often, students of diverse ethnic backgrounds feel that we have to blend in with the majority culture [and] that our differences are not appreciated by society in the U.S. Thus, an environment that supports our true selves, inclusive of our ethnicity or culture(s), is rare and appreciated.
  • Prioritize multicultural competency development and practices. It’s OK to not know how to help those from different backgrounds, but it’s not OK to avoid or isolate this disparity in mental health. Attend trainings, read and expand your learning to reach diverse groups.
  • Mentor students of diverse backgrounds. If it were not for my mentor, I would never have entered the field of clinical mental health counseling. I always knew I wanted to accomplish a Ph.D. in psychology or mental health, but as I neared the end of my undergraduate studies, I wasn’t sure which programs to consider. Meeting a faculty member from my master’s program who was willing to answer my questions and who believed in me enough to tell me to apply changed my life. From observing my volunteer work with at-risk youth, she said to me, “You are a counselor.” We as therapists and counselors know that words have power. Such encouraging words can be powerful for students who do not always feel welcome, who are first-generation graduate students and who are simply new to the field of mental health.


Courtland Lee

Courtland Lee, past president of ACA, professor in the counselor educator program at the Chicago School of Professional Psychology’s Washington, D.C., campus and author of numerous books, including Multicultural Issues in Counseling: New Approaches to Diversity

If we are thinking about attracting more people of color to the counseling profession, counselor education programs and the profession in general need to consider a number of socioeconomic and cultural factors.

First, from a very pragmatic perspective, given significant socioeconomic gains for people of color in the last 50-plus years, talented students of color have greater access to financially lucrative careers. While counseling is a noble profession, it does not pay as much as other career paths. This is a real consideration for many potential counseling students of color as they think about their futures.

Second, counselor education programs must consider whether the culture of their program is relevant and welcoming to students of color. Do they feel welcomed at an institution? Do they perceive the counseling curriculum to be relevant to their cultural realities? Do they see people who look like them as successful counseling professionals?

People of color and other economically marginalized groups have historically been underrepresented at college, and especially [at] higher degree levels. Given that the practice-level degree in counseling is a master’s degree, that basic demographic impacts the number of folks from these groups that have had adequate financial and other access to successfully pursuing the degree.


Lance Smith

Lance Smith, associate professor of counseling at the University of Vermont and author of numerous research papers analyzing diversity issues in the counseling profession

We should address the lack of scholarship that explores levels of diversity among counseling master’s programs, along with the absence of literature identifying effective recruitment and retention strategies for students from underrepresented groups. To the best of my knowledge, there are currently no published articles that have purposefully gathered representation
data for CACREP-accredited master’s degree programs.

A few years ago, my colleagues and I attempted to address this gap by looking at the extent to which CACREP-accredited master’s programs attend to representation of people of color, individuals with (dis)abilities [and] lesbian, gay, bisexual and transgender persons within admissions, enrollment and graduation data (“Attending to diversity representation among CACREP master’s programs: A pilot study” published in the June 2011 issue of The International Journal for the Advancement of Counseling). In a nutshell, we simply wanted to know if programs collect student admission, enrollment and graduation rate data regarding the social identity markers of race/ethnicity, gender identity, sexual orientation and ability status.

We reached out to all 238 CACREP programs at the time, of which 85 completed our entire survey. What we found was that just over half of the responding programs did not retain representative diversity data, and of the programs that did, emphasis was placed on enrollment data and not graduation data. Moreover, most of the data were associated with race/ethnicity only — a little bit being associated with (dis)ability and none of it associated
with sexual orientation or gender nonbinary identities.

So, is this lack of attention to representative diversity an expression of institutional prejudice within the field of counseling? Perhaps not overt, intentional prejudice, but I would suggest covert, complicit prejudice is at play. To quote Paulo Freire, “Washing one’s hands of the conflict between the powerful and the powerless means to side with the powerful, not to be neutral.” If we as counselor educators are not interested in gathering or keeping representative diversity data regarding enrollment, retention and graduation, then we are ignoring the white/straight/cis homogeneity within the profession and, thus, complicit in reinforcing the inequitable status quo.

The importance of retaining the demographic characteristics of accepted applicants who choose not to enroll is also very important when considering issues of recruitment. Counseling programs that maintain this information have access to data that can be very helpful in evaluating their strategies for recruiting diverse students. If such an evaluation reveals a consistent pattern of applicants from underrepresented groups choosing to go elsewhere, faculty need to sit together and discuss what they need to do differently.

In terms of attracting racially/ethnically diverse applicants, the materials that programs use to market their programs have been found to make a difference. There was a study … that found that professional psychology programs that provided materials emphasizing nondiscrimination policies, diversity-based financial aid, commitment to diversity training and recruitment, [and] multicultural minors and that had more racial/ethnic and LGBTQ-specific content attracted greater numbers of racially/ethnically diverse students.

Counselors who work in community counseling agencies can either become members of or form a diversity committee where their primary task is to address a representation of diversity in their agency to ascertain how diverse their staff is and then actively recruit more diverse staff members. This could happen at a community agency [or] it could happen at college centers, which are usually more active with this kind of recruiting. This could even happen in a private practice consortium, where a group of people in private practice are loosely connected. They can form a diversity committee there, and they can actively recruit counseling staff.

Counselors can also reach out to counselor education programs and actually request that they be an internship site for counseling students and specifically request that they would like to recruit and draw and mentor counseling interns who are from traditionally underrepresented groups. That would put a bug in the ear of local counseling programs that there are people who are specifically seeking to train, mentor and supervise counselors who come from traditionally underrepresented groups.

Counselors can advocate with state licensure boards and state legislatures to gather data about the diversity of counselors in their state. For example, here in Burlington [Vermont], we have one clinical mental health counselor of color [despite the fact that] we are also a refugee resettlement city — with a population of about 17 to 20 percent of residents who are refugees and people of color.

Practicing counselors can reach out to school counselors to offer to come to career fairs — specifically schools with diverse student bodies — and speak to students about the counseling profession and the need for a more diverse population of counselors.

Practicing counselors can also reach out to campus groups and clubs — African American Student Unions, LGBTQ groups, disability rights groups, etc., and offer to talk to undergraduates about the counseling profession and the need for counselors with more diverse stories
and backgrounds.


Sylvia Nassar

Sylvia Nassar, member of the committee that developed the Multicultural and Social Justice Counseling Competencies, a professor and doctoral program coordinator of counselor education at North Carolina State University, and a researcher and author with a focus on Arab American issues

The counseling profession, like other master’s-level professions, has increased in terms of diversity as a simple parallel to increases in diversity at rates of graduate-degree acquisition. Moreover, the efforts of CACREP as well as individual educational institutions and other groups to systematically recruit and retain more students from marginalized groups has strengthened the profession generally and, in particular, the professional counseling associations and special interest groups with specific diversity foci, thus positively perpetuating diversity at multiple levels throughout the profession.

The historical trend of vulnerable groups within the overall population needing within-group representation in their counseling and advocacy services within their own communities [and] at national levels continues to drive the need for additional diversity. For example, refugees, veterans, individuals from marginalized sexual identity groups, along with many others, present growing needs for counseling and advocacy and, thus, need to be better represented by counselors and advocates from their own population groups.

These areas of diversity need to be intentionally and systematically addressed within broader diversity initiatives such as those promoted by CACREP, educational institutions, etc.

The Multicultural and Social Justice Counseling Competencies (MSJCCs), endorsed both by the Association for Multicultural Counseling and Development and the American Counseling Association in 2015, provide a promising perspective on recognizing and addressing diversity throughout the counseling profession. As the MSJCCs become operationalized for use by counselors and counselor educators and supervisors, professional counselors will ideally broaden their current thinking of diversity and challenge themselves to increase their inclusivity in conceptualizing diversity among their clients and students.



To access the Multicultural and Social Justice Counseling Competencies, visit counseling.org, click on “Knowledge Center” and then click on “Competencies” in the drop-down menu.




Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Embodying a critical counseling practice and radical wellness

By Javier F. Casado Pérez August 7, 2017

A supervisee committed to a multicultural counseling practice approached me feeling distressed and self-critical. In my capacity as a doctoral candidate in counselor education and supervision, I had worked with this supervisee for several months and had also worked with him the year prior. At this point, he expressed uncertainty about his most recent session, including a fear that he had pushed the client, a young black female, away.

In watching the recording of the session, I observed an authentic and rich conversation. The client expressed appreciation at having the opportunity to speak so freely about her experience as a black college student. I asked my supervisee what he thought he had done to distance the client. He responded, “Talked too much about race.”

Another counselor-in-training disclosed that a client had expressed a desire for a referral because of the counselor’s noticeable accent. The counselor, a brown Latina, was feeling distraught because this was not the first such incident she had experienced. I recommended that she read through the Multicultural and Social Justice Counseling Competencies (MSJCC) and become familiar with the effects that privilege and microaggressions can have on counseling relationships. I also suggested that she broach a conversation with the client about the discrepancy between the client’s concern and the counselor’s apparent mastery of the English language. The counselor was reluctant, however, explaining, “I was told not to bring up the language issue unless the client brings it up first.”

A client, a middle-aged woman of color, shared her frustration and anger about previous counselors and her lack of confidence in the counseling process. According to her chart, she has issues managing her anger and has been diagnosed with an unspecified psychotic disorder. According to the client, her previous counselors and other service providers were faithless and always assumed she was angry. When I asked how her lack of success with previous counselors might be related to her devout religious beliefs and strong identity as a Latina, she responded, “I’ve thought about that a lot, but no one’s ever asked.”    

Broaching privilege in professional counseling

These illustrations are composites, each drawn from a multitude of individual stories that I have participated in or been consulted about. The MSJCC were discussed at different stages of the supervision or consultation in each of these situations. Each time, the counselor-in-training, supervisee or colleague identified the MSJCC as nonessential to their case.

As a queer, cisgender, brown Latino male and critical race feminist counselor, educator and supervisor, I have been involved in critical diversity and anti-oppression work for almost a decade. My undergraduate studies in Hawaii woke me up to Native rights, colonialism and sociopolitical activism, setting me on the path of sociocultural critique and advocacy. I advocated for minoritized clients and resisted colorblind human service practices throughout my graduate training and clinical experience. I have had the privilege of serving on diversity enhancement committees, facilitating anti-microaggressions workshops and participating in activism in the academic and community spheres. Throughout these experiences, my passion and radical love for the practice of professional counseling have only grown and strengthened. 

At the same time, I have been discouraged by continued encounters with narratives that minimize and decentralize the importance of critical multiculturalism and social justice activism in counseling. Narratives, for example, that cast the MSJCC as a supporting character and not in the leading role, holding firmly to exhausted and culturally clumsy theories of human functioning.

The MSJCC call for professional counselors to be ready, willing and able to challenge injustice and oppressive ideologies in the work that we do. The MSJCC framework compels counselors toward action, or an embodied competency that exists in the ways we move through our world and manifests through our behaviors both inside and outside the counseling room. In the Counseling Today article “Social justice counseling: ‘Fifth force’ in the field,” Manivong Ratts, Michael D’Andrea and Patricia Arredondo described the counselor committed to social justice as one who recognizes power, privilege and oppression and their detrimental effects on client mental health and well-being. For counselors, this recognition means taking risks, including choosing conversations that destabilize social injustices despite the potential for discomfort.

The choice not to discuss power, privilege and oppression is in itself a privileged one. Derald Wing Sue defines social privilege as the ability to freely and successfully avoid interactions with those social identities that differ from our own. For whites, this means avoiding people of color and being able to comfortably choose to interact almost exclusively with lighter shades of skin. For men, this means passively dismissing women while paying special attention to the contributions and authority of men.

But privilege expands far beyond this definition. Privilege is the ability to disregard or be apathetic toward not only social identities but also indigenous concerns, cultural differences and issues of inequality when they don’t affect us (at least on the surface). Counselors also carry social privilege and the ability to choose between perpetuating or uprooting oppressive ideologies.

As counselors, we are trained to be aware of the power and privilege inherent in our roles and our responsibility in advocating for cultural and social justice. In their groundbreaking piece for the Journal of Counseling & Development (JCD), “Broaching the Subjects of Race, Ethnicity and Culture During the Counseling Process,” Norma Day-Vines and colleagues called for us to broach difficult subjects and discuss the sociocultural underpinnings inherent in clients’ counseling concerns, even when doing so generates discomfort. On the other hand, nonintersectional and colorblind counseling — counseling that disregards the importance of social identities in a politicized, racialized and sexualized world in order to appear unbiased — function not only to avoid broaching but also to reproduce and reinforce inlaid ideologies and perceptions that have come to be known as implicit biases.

Through multicultural training, counselors may become aware of the privilege they carry. But as avid blogger and radical queer black feminist Mia McKenzie says, “It is not enough to acknowledge your privilege. Acknowledging it will never make it better, will never, ever change anything. At some point, you must act against it. This is that point.”

Decision-making in a critical counseling practice

In a time of great social unrest and political uncertainty, doing more than acknowledging privilege becomes essential. For counselors, our privileged position is revealed when we choose to disregard ideologies of oppression or domination that manifest within counseling spaces. Instead, we focus on individuals’ presenting problems — the areas of clinical concern that our clients disclose at the beginning of our work. The debate over a counselor’s responsibility to honor the presenting problem or address implicit issues of justice and equity is long-standing. The MSJCC make evident that the way forward is both/and, not either/or.

For example, my client presented with social anxiety and severe panic at the start of our work together. A brown South American woman with a distinct accent, she was also the sole woman of color in an otherwise all-white and predominantly male workplace. The question was, should I focus on her symptoms of social anxiety or her experience of being a racial, ethnic and gender minority? Could I do both?

In another memorable session, a client — a white North American cisgender man — exclaimed that most women and people of color were just too sensitive. He said that their complaints of mistreatment and discrimination were just subjective interpretations and not based in objective fact. I have heard this line many times in my life. I was not surprised, but it still made my blood boil.

As a queer counselor of color, I had a choice that I needed to make:

1) I could say nothing, maintaining mutual comfort by reflecting the client’s frustration and moving on (broach avoidance).

2) I could challenge only the obvious generalizations in this belief, perhaps asking how helpful this belief was in helping the client connect to others (colorblind counseling).

3) I could call into question the ideology of oppression (as critical pedagogue Paulo Freire termed it) couched in such a statement (i.e., the world is just and equal; women and people of color just cannot handle the real world). This choice would express not only the effects of the client’s statement on me but also challenge the oppression the client might enact on others by embodying this ideology.

Behind closed doors with only the MSJCC to hold me accountable, the choice was mine. All my own.

Herein lies the paradox. The most comfortable choice brings about the least therapeutic change and potentially the most social damage. The most uncomfortable choice carries as much risk as it does potential for therapeutic change, while possibly preventing the most social damage. This is one of the reasons that these are called difficult but crucial conversations.

I do not disclose how I chose to respond to these scenarios because it is not my goal to teach “do as I do.” My goal here is to point out the implicit contradictions in the three choices and the consequent effects of perpetuating social injustices in two of the three choices — regardless of intention.

Moving toward radical wellness

Multiculturalism is a deeply contested term. Nancy Fraser, critical theorist and feminist, points out that traditional multiculturalism has too often functioned to essentialize differences while failing to recognize the interplay between social politics and identity. This is to say that simply recognizing that differences exist between individuals or groups is not enough to make visible the structures that make those differences the basis for injustice and inequity.

Whereas traditional multiculturalism calls for us to be aware and appreciative of cultural differences, critical multiculturalism demands that we respond to issues of injustice and oppression that affect individuals on the basis of those differences. This reorientation ties together critical multiculturalism with social justice, producing a practice that affects the wide-reaching work that counselors perform.

In Towards Psychologies of Liberation, Mary Watkins and Helene Shulman point out that “critical consciousness involves decoding the social lies that naturalize the status quo, while searching for alternative interpretations of one’s situation.” As counselors, when we embody a critical practice through ways of being in our work, we are attentive to both dismantling dominant ideologies and providing a reinterpretation (or reframing) of social dynamics among the individual, their clinical concerns and the world around them.

Through these reinterpretations, we begin to model a radical wellness that is characterized by an emotional and mental health simultaneous to critical social consciousness. In the JCD article “The Wheel of Wellness Counseling for Wellness: A Holistic Model for Treatment Planning,” Jane E. Myers and colleagues defined wellness as “a way of life oriented toward optimal health and well-being in which body, mind and spirit are integrated by the individual to live more fully within the human and natural community.”

I define radical wellness as a way of life that is oriented toward optimal collective health and well-being, which consequently feeds individual health and well-being. The individual integrates critical consciousness into the body, mind and spirit for the purpose of working against inequality and social injustice that is deeply rooted in societal communities. As counselors, we are uniquely positioned to embody and model this radical wellness by broaching conversations that illuminate the inextricable relationship between Watkins and Shulman’s “social lies,” societal problems and individual issues.

The MSJCC do not require that counselors be wholly comfortable in having these conversations but rather that they internalize the importance of taking the risk. Conversations about sociocultural and intersectional issues help to bridge the roles of counselor, advocate and activist. Creating an environment that helps clients trust us enough to express fear, share doubt, reveal uncertainty and risk exposing biases is critical to this endeavor.

Yes, these conversations can be hard, and they may fall short of their aim at times, but they are conversations that spark deeper individual and social change. When clients and counselors situate themselves as inextricably linked to the greater social fabric, they can experience their lives in shared space with those whom they may have previously judged as “other.”






Javier F. Casado Pérez is an assistant professor of counselor education at Portland State University and a national certified counselor. He is seeking colleagues to form a group blog on subjects such as critical theories, multiculturalism and social justice in counseling practice and epistemologies. For more information, contact him at j.casadoperez@pdx.edu.

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