Multicultural counseling and psychotherapy

A clinician lacking cognitive empathy may be unable to understand the client’s belief in fate. A culturally informed clinician may view this attribution to fate as an encouraging healthy cognitive expression to overcome grief and move on with his/her life. Hence, it is essential to have cognitive empathy as a clinician treating an Asian client by learning about Asian cognitive structures rooted in cultural and social schemas, either through literature or through direct interpersonal experiences (Hong & Ham, 2001). Cultural empathy enables the clinician to understand the underpinnings of their clients’ cultural experiences as well as emotions.

Cultural empathy can be conveyed by intracultural empathy and intercultural empathy. Clinicians who have unconsciously accepted their own culture may find challenges in feeling appreciation and devotion for their Asian clients. Clinicians who want to develop intercultural empathy need to experience the feelings of clients who are attached to their cultural events. Intracultural empathy is the collective feelings and emotions shared by all individuals in the same culture toward a religious cultural event. Intracultural empathic process is created by shared experiences.

For example, a child feels happiness with all members of the society over a festival or a religious event. Cultural empathy based on subjective experience may require the clinician to learn this form of empathy by getting involved in the social and cultural environment (Hong & Ham, 2001). In person-centered therapy, the clinician helps the client to express themselves for the purpose of gaining insight and moving toward self-actualization. This may be particularly challenging for Asian clients who feel inhibited to express themselves freely to strangers (Hong & Ham, 2001).

Asians are stereotypically described by others as shy, reserved, self-disciplined, quieter, and less likely to express strong emotions when compared to Caucasians. Asians have more rules in the expression and experience of emotions than Western culture and consequently, Asian have less emotional terms to communicate with others. Display of strong emotions is considered to be immature or indicate a lack of control, especially among adolescents in the Asian culture (Sue & Sue, 2003).

Counseling techniques that center on emotions will put the client in an awkward position causing shame and embarrassment to Asian clients. Studies indicate Asian American students are more responsive to the latter form of indirect acknowledgement of emotions. Care and concern are demonstrated by taking care of physical needs of the partner than by expressing care verbally. Hence, it may be advisable to directly focus on behaviors and indirectly focus on emotions by identifying how other family members are meeting each other’s needs (Sue & Sue, 2003).

Psychotherapy is a process of interpersonal communication and involves both verbal what is said and nonverbal how it is said elements. Direct and confrontive techniques can be misconstrued by Asian clients as lack of respect to the client, as well as a rude form of communication. Kinesics refers to bodily movements such as facial expressions, posture, characteristics of movement, gestures and eye contact. Kinesics is culturally conditioned and influences nonverbal communication. Smiling in Asian cultures is a sign of weakness. Control and restraint over strong feelings is a sign of maturity and wisdom.

Clinicians unaware of this may assume that their Asian clients may be out of touch with their feelings (mood and affect). Avoidance of eye contact may be a sign of “respect” and deference to authority, a clinician may very easily misconstrue this as a lack of intelligence, shyness, and inattentiveness. Paralanguage is a term that refers to vocal cues used to communicate such as loudness, silences, hesitations, voice and pauses i. e. how we greet and take turns in speaking. Paralanguage is usually typical of Asian cultures and Asian clients tend to be silent as a sign of respect and politeness.

Therapist should be cautious of imputing incorrect motives such as lack of desire to speak or a sign of ignorance. Asians consider loud talking as aggressive, lack of control and anger. Directness of conversation or the degree of frankness also varies among cultures. Western cultures emphasize on being precise and frank and not “beating around the bush” which could be misconstrued by the Asian client as rude and lacking finesse. Clinicians should be cautious of their own nonverbal cues because they unconsciously reflect biases and trigger stereotypes of people.


Baruth LG and Manning ML (2003): Multicultural counseling and psychotherapy: A lifespan perspective (3rd ed. ). Columbus, OH: Prentice Hall. Chin JL (1993): Transference. In: Chin JL, Liem JH, Ham MD and Hong CK. Transference and empathy in Asian American psychotherapy (pp. 15-29). Westport, CT: Praeger. Hedstrom J (1994): Morita and Naikan therapies: American applications. Psychotherapy 31(1): 154-160. Hong GK and Ham MD (2001): Psychotherapy and counseling with Asian American clients: A practical guide. Thousand Oaks, CA.

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