Counseling Diverse Clients
Embracing Cultural Competence and Narrative Therapy in Diverse Counseling Practice
Counseling Diverse Clients
Patricia Fleetwood
Post University
HSV554_31_Broaching the Human Experience in Counseling_2025_26_TERM5
Dr. Zeng
Counseling Diverse Clients
“Did you know that over 30% of clients feel misunderstood by their counselors due to cultural differences?” This statistic underscores the critical need for culturally responsive practices in counseling. Scholarly research strongly supports that cultural misunderstanding is a major driver of dissatisfaction and premature termination in therapy. Research indicates that, in cases where counselors lack cultural training, clients from minority groups may account for up to 70% of premature dropouts (Stingl & Hanewald, 2025).
Journey with me as I elaborate on counseling diverse clients. Counseling and therapeutic styles can vary greatly among professionals, and they often draw upon various theoretical orientations. In response to the question, “What is my counseling or therapeutic style and theoretical orientation?” I am not particularly drawn to one specific style because each client is unique, and their needs and preferences differ. I prefer to implement best practices according to my clients’ needs.
There are several approaches I would employ depending on each client’s situation, such as Cognitive Behavioral Therapy (CBT), which focuses on identifying and changing negative thought patterns and behaviors. CBT teaches clients how to challenge irrational beliefs and develop coping strategies commonly used for anxiety, depression, and many other mental health concerns (Huey et al., 2023).
Another therapeutic approach I would use with clients is Psychodynamic Therapy. This structured approach helps uncover unconscious thoughts, examine past experiences, and resolve deep-seated conflicts that influence current behavior and emotional distress. It also serves as a mechanism to explore hidden feelings, allowing individuals to understand how past experiences, such as childhood relationships, have shaped their current personality and behaviors (Rodriguez et al., 2008).
I believe getting to the root of issues is significant in counseling clients in general, but especially important when counseling diverse clients in order to avoid misdiagnosis, ensure cultural competence, and build trust. It moves beyond superficial symptoms to address unique cultural contexts such as race, immigration, and religion that shape a client’s worldview, enabling more personalized treatment and a stronger therapeutic alliance.
Lastly, I am most drawn to narrative therapy because it empowers clients to share their varied lived experiences and cultural wisdom. It allows me to walk alongside my clients as they navigate their stories, rather than imposing expert advice, while assisting them in re-authoring their lives in ways that honor their heritage, resilience, and personal values (Semmler & Williams, 2000).
When we sit down to hear someone’s story, we are doing more than simply listening; we are witnessing their unique way of making sense of the world and their place within it. Narrative therapy embraces this powerful truth, recognizing that the stories we tell about ourselves shape not only how we view our past, but also how we imagine our future. It is an approach that honors each person’s expertise in their own life while gently opening doors to new possibilities and perspectives. As I employ narrative therapy techniques with clients, I can create space for new meanings, renewed hope, and empowering ways of telling their stories (Semmler & Williams, 2000).
Narrative therapy interventions focus on separating the person from the problem in order to re-author empowering life stories. These interventions are designed to be respectful, non-blaming, and culturally sensitive, focusing on the client’s agency and unique experiences. The beauty of narrative therapy lies in its attention to detail and meaning (Semmler & Williams, 2000).
The gold standard for all therapies, including narrative therapy, is active listening, as well as carefully balancing and guiding the process while respecting the client’s autonomy and agency. Ethical considerations include informed consent, ensuring that the client fully understands the nature and purpose of narrative therapy techniques and consents to participate. It is also essential to maintain client confidentiality and privacy, especially when dealing with sensitive or traumatic material, while refraining from imposing my own narratives or interpretations onto the client’s story. Instead, I would support clients in developing their own preferred narratives and meanings.
Narrative therapy interventions often begin with externalization, which reframes the client’s problems as separate from the individual, treating “anxiety” as a visitor rather than an identity (Semmler & Williams, 2000).
Next is deconstruction, which systematically breaks down complex or overwhelming stories into smaller, more manageable parts in order to identify their origins and maintaining factors. This is followed by unique outcomes, sometimes referred to as “sparkling moments,” which identify moments where the client resisted the problem or acted outside the problem-saturated narrative.
Another important intervention is re-authoring, which involves collaborating with the client to construct new, empowering narratives that highlight their strengths, values, and alternative possibilities.
One narrative intervention I believe is especially significant is outsider witnessing. This technique can enhance the therapeutic experience, particularly for diverse clients, by involving people outside the therapeutic relationship who can provide support and validation for the client’s story. Listening without judgment helps clients feel understood and valued, particularly if they come from marginalized backgrounds where their narratives may have been overlooked. The presence of an outsider witness can also create a more communal and supportive atmosphere. In many diverse cultures, community and social connections play a critical role in individual identity. This communal aspect can help clients reconnect with their cultural roots and feel supported by their peers (Semmler & Williams, 2000).
Several factors have shaped my counseling style and theoretical orientation. Social conditioning has influenced me to value empathy, active listening, and open communication. My upbringing in a military environment that encouraged emotional expression and understanding has been pivotal. Additionally, my experiences working in nursing and building close friendships with individuals from diverse cultural backgrounds have broadened my perspective and strengthened my appreciation for the uniqueness of each person’s experiences.
When working with Jewish American or multiracial clients, it is crucial to examine the cultural aspects of my counseling style. Understanding and respecting their unique cultural values, religious practices, and lived experiences is essential (Berman & Woolley, 2025).
Several critical aspects of narrative style and theoretical orientation should be examined and potentially revised to ensure culturally competent and effective therapeutic relationships with Jewish American or multiracial clients (Berman & Woolley, 2025).
One important consideration is cultural sensitivity in language. For Jewish clients, this includes understanding specific cultural terms, religious references, and historical contexts, such as the significance of Shabbat or Yom Kippur (Berman & Woolley, 2025). For multiracial clients, it involves recognizing the diversity within their identities and avoiding homogenizing language.
Additionally, it is important to be aware of narrative traditions that may hold significance for Jewish American clients, such as Talmudic storytelling methods, while also recognizing that family history and cultural heritage often play major roles in the identities of multiracial clients (Berman & Woolley, 2025).
As a therapist from a different cultural background, I may face challenges in understanding and empathizing with Jewish American or multiracial clients. One challenge may involve a lack of firsthand experience with the specific cultural nuances and historical experiences these clients bring into therapy. To overcome these challenges, I would engage in cultural humility, recognizing my limitations and remaining open to learning from the client. This would include seeking educational resources, consulting colleagues with relevant expertise, and actively listening to clients’ experiences and perspectives.
There are two possible forms of countertransference that may arise. The first is over-identification or idealization of the client’s experiences. This can occur when therapists project their own values or experiences onto clients, assuming they fully understand the client’s perspective. I do not anticipate this occurring frequently with culturally diverse clients because I have not shared their lived experiences. Conversely, I may experience negative countertransference, which can involve discomfort or biases triggered by the client’s background, potentially manifesting as avoidance or reduced empathy (Sue & Sue, 2016).
To address countertransference, I must engage in ongoing self-reflection and cultural competence training. Consulting with colleagues and seeking supervision can help therapists gain insight into their reactions and biases, allowing them to provide more effective and culturally sensitive care (Sue & Sue, 2016).
When working with culturally diverse clients, I may experience a range of countertransference reactions, from anxiety about my own cultural competence to protective feelings rooted in shared experiences, all of which require continuous reflection. Some challenges may include preconceived notions or biases about certain cultures, which can lead to misunderstandings or misinterpretations of clients’ behaviors or needs.
I feel strongly that I must guard against countertransference related to advocacy by maintaining appropriate professional boundaries. As a nurse, I have always been taught that I am my patient’s advocate. I recognize this as a potential dilemma when functioning as a therapist, because the dual roles of nurse and therapist may sometimes create conflicting loyalties between promoting physical health and supporting psychological well-being.
In response to the question regarding my thoughts and beliefs about the “unseen,” including the presence and potential power of spirits and spirit possession, I will quote John Bytheway: “A man with experience is never at the mercy of a man with an opinion.”
I firmly believe that personal lived experience or spiritual conviction can be more powerful than intellectual debate. This raises the question: Who can challenge another person’s lived experience?
The concept of the “unseen,” which encompasses beliefs about spirits, spiritual dimensions, and spirit possession, is a subject of considerable interest across many cultural, religious, and philosophical traditions.
Different cultures hold diverse understandings of the unseen. Many Indigenous religions include beliefs in spirits inhabiting nature or ancestral realms. Rituals and practices often serve as methods of communicating with or invoking these spirits (Wendt et al., 2022). Christians, for example, believe in angels and demons. Throughout history, many civilizations have believed in the existence of spirits and the possibility of spirit possession. Such beliefs were especially prevalent during the Middle Ages, when exorcisms became common practices in various religious traditions.
In contemporary society, interest in the unseen has manifested in paranormal research, spiritualism, and New Age spirituality. These movements often blend traditional beliefs with modern interpretations of spirituality and consciousness.
Belief in the unseen can provide individuals with meaning, comfort during grief, or guidance in difficult times. It challenges strictly materialistic perspectives by suggesting that not all aspects of existence can be fully understood through empirical evidence alone.
I firmly believe in the unseen God who created the stars and placed them in the heavens, in His omnipresence, omnipotent power, and loving compassion for His creation. In counseling, it is crucial to respect clients’ beliefs, including those related to spirits or spirit possession, because these beliefs are often deeply rooted in cultural and religious traditions. Understanding them as culturally significant fosters rapport and trust.
I would approach clients’ beliefs with openness and curiosity. When clients believe their problems are connected to supernatural forces, it is essential to explore these beliefs with empathy rather than dismissing or challenging them.
Research by Pargament et al. (2013) emphasizes the importance of respecting clients’ religious and spiritual beliefs in therapy. Clients who feel their beliefs are respected are more likely to engage in therapy and experience positive outcomes.
These differences in belief systems may create opportunities for deeper exploration of the client’s worldview and sources of distress. By maintaining a nonjudgmental stance and prioritizing the client’s well-being, the therapeutic alliance can remain strong.
When clients believe their mental health struggles are related to spirit possession, it is crucial to approach these beliefs with cultural sensitivity. Open and nonjudgmental discussions can help clients explore their concerns safely.
If clients believe that only an Indigenous healer or shaman can address the issue, I would respect their choices. When appropriate and with the client’s consent, collaboration with traditional healers may help integrate culturally meaningful healing practices into therapy. I would support culturally significant rituals, such as chanting or incense burning, when they hold deep spiritual importance for the client.
If the counseling agency where I worked rejected Indigenous healing practices and prohibited their integration into counseling, I would face both an ethical and cultural dilemma. In such cases, it would be important to advocate for culturally competent care while also respecting agency policies. One approach would involve engaging in dialogue with leadership about the importance of cultural competence and presenting research supporting culturally sensitive care (Gone, 2010).
Ultimately, the goal would be to find a balance that respects both agency policies and the cultural needs of clients.
Spirituality and religion are related but distinct concepts. Religion typically involves organized belief systems, rituals, institutions, doctrines, and practices. Spirituality, on the other hand, is broader and more personal. It encompasses an individual’s sense of connection to something greater than themselves, their search for meaning, and their pursuit of personal growth and self-discovery.
A client can absolutely be spiritual without being religious. Spirituality does not require adherence to an organized religion. Individuals may embrace beliefs in universal energy, nature, personal intuition, or philosophical understandings of existence and consciousness. Spirituality may also manifest through meditation, mindfulness, yoga, or time spent in nature.
Spirituality is highly subjective and does not need to be tied to religion. For mental health professionals, recognizing and respecting clients’ spiritual beliefs, or lack thereof, can be essential in providing effective support. Therapeutic approaches may incorporate spiritual discussions or practices when they align with the client’s values.
Research by Zinnbauer et al. (1997) explored the distinction between religion and spirituality, finding that spirituality often reflects a more individualized approach to belief and practice. Therapists should differentiate between these concepts in order to understand clients’ unique needs and perspectives.
The integration of spirituality into counseling and psychotherapy is supported for several reasons. First, spirituality can provide clients with meaning and purpose, both of which can motivate healing and growth. It addresses the whole person, including emotional, physical, mental, and spiritual dimensions.
Research by Emmons (2000) suggests that spirituality contributes to psychological well-being by promoting positive emotions, resilience, coping strategies, and hope.
Second, spirituality can serve as a source of resilience during adversity or trauma, helping clients understand and cope with difficult experiences in ways that support post-traumatic growth.
Third, spirituality is often deeply intertwined with clients’ identities and values. Ignoring or dismissing this aspect of their lives may hinder therapy and weaken the therapeutic alliance. Spiritually engaged clients may also be more motivated to participate actively in treatment and healing (Emmons, 2000).
Counselors may hesitate to integrate spirituality or religion into therapy for several reasons. One common concern is the fear of imposing personal beliefs or making assumptions about a client’s spirituality. Counselors may also worry about alienating clients who hold different beliefs or violating professional boundaries.
Another reason for hesitation may be a lack of training or confidence in addressing spiritual issues effectively (Emmons, 2000). Counselors may fear causing harm, offending clients, or mishandling deeply personal topics related to religion or spirituality.
A counselor’s own negative experiences with religion, or strong personal beliefs, may also affect their comfort level or objectivity.
Although these concerns are understandable, counselors can overcome reluctance through education, supervision, and self-reflection. By developing cultural competence and learning to ask open-ended questions while practicing active listening, counselors can create safe, respectful spaces for clients to explore their spiritual beliefs (Emmons, 2000).
It is crucial for counselors not to assume a client’s racial or ethnic identity based on appearance, as doing so constitutes a form of racial microaggression (Kivlighan et al., 2019). Assumptions about identity can lead to miscommunication, mistrust, and weakened therapeutic relationships. Instead, counselors should adopt a client-centered approach that respects self-identification.
Racial and ethnic identities are deeply personal and shaped by culture, family history, societal factors, and lived experiences. Misidentifying a client may overlook important aspects of their identity and worldview.
Counselors can begin by asking clients how they identify racially or ethnically and which aspects of their identity are most meaningful to them.
Cultural competence is essential for effectively supporting diverse clients. Misidentification can result in misunderstandings and ineffective counseling practices that fail to resonate with clients’ beliefs or values.
Establishing trust is foundational in counseling. Assumptions about identity may create feelings of alienation or mistrust, impeding the therapeutic alliance (Kivlighan et al., 2019).
Clients may belong to multiple racial or ethnic groups or hold intersecting identities involving gender, socioeconomic status, or sexual orientation. Recognizing this complexity is essential for understanding clients holistically.
Allowing clients to define their own identities promotes autonomy and empowerment while encouraging open communication and deeper exploration of self-understanding (Kivlighan et al., 2019).
The process of understanding how clients self-identify begins with open-ended questions. For example, counselors might ask, “How do you identify in terms of your racial or ethnic background, and what does that identity mean to you?” (Kivlighan et al., 2019).
This should be followed by active listening, paying close attention to verbal and nonverbal cues that reflect how clients perceive themselves.
Counselors can also explore clients’ cultural upbringing, traditions, values, and customs to gain deeper insight into identity formation.
Establishing a strong therapeutic alliance is vital. Counselors should create a safe and respectful environment where clients feel comfortable discussing identity and lived experiences. Validation of clients’ self-identification can strengthen trust and support deeper exploration.
Understanding racial and ethnic identity may require ongoing discussion throughout counseling. As clients reveal more about themselves, counselors should remain open to refining their understanding. Seeking supervision or consultation when challenges arise can further support culturally competent practice.
Counselors play a critical role in creating inclusive and respectful environments that acknowledge the complexity of racial and ethnic identities. By refraining from assumptions and engaging clients in meaningful discussions about identity, counselors can enhance therapeutic effectiveness and support clients more holistically.
The American Counseling Association (ACA) provides guidelines emphasizing cultural competence and respect for clients’ self-identified racial and ethnic identities (ACA, 2020).
References
American Counseling Association (ACA). (2020). ACA Code of Ethics (2020). ACA.
Berman, A. J., & Woolley, S. (2025). Barriers to initiating psychotherapy faced by Jewish-identified people in the United States. Journal of Religion and Health, 64(1), 225–243. https://doi.org/10.1007/s10943-024-02097-2
Emmons, R. A., & Crumpler, C. A. (2000). Gratitude as a human strength: Appraising the evidence. Journal of Social and Clinical Psychology, 19, 56–69.
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Pargament, K. I., Exline, J. J., Jones, J. W., & Henderson, D. A. (2013). Religious and spiritual struggles. In P. L. Benson (Ed.), Religion and Spirituality Across Cultures (pp. 123–145). Springer.
Rodriguez, C. I., Cabaniss, D. L., Arbuckle, M. R., & Oquendo, M. A. (2008). The role of culture in psychodynamic psychotherapy: Parallel process resulting from cultural similarities between patient and therapist. The American Journal of Psychiatry, 165(11), 1402–1406. https://doi.org/10.1176/appi.ajp.2008.08020215
Semmler, P. L., & Williams, C. B. (2000). Narrative therapy: A storied context for multicultural counseling. Journal of Multicultural Counseling and Development, 28(1), 51–62. https://doi.org/10.1002/j.2161-1912.2000.tb00227.x
Stingl, M., & Hanewald, B. (2025). Culturally sensitive psychotherapy—Technique or attitude? Frontiers in Psychology, 16, 1599855. https://doi.org/10.3389/fpsyg.2025.1599855
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Wendt, D. C., Huson, K., Albatnuni, M., & Gone, J. P. (2022). What are the best practices for psychotherapy with Indigenous peoples in the United States and Canada? A thorny question. Journal of Consulting and Clinical Psychology, 90(10), 802–814. https://doi.org/10.1037/ccp0000757
Zinnbauer, B. J., Pargament, K. I., Cole, B., Rye, M. S., Butter, E. M., Belavich, T. G., Hipp, K. M., Scott, A. B., & Kadar, J. L. (1997). Religion and spirituality: Unfuzzying the fuzzy. Journal for the Scientific Study of Religion, 36(4), 549–564. https://doi.org/10.2307/1387689
