If clinicians are not as proficient at treating minorities and people of alternative cultural background, then unless this fact is publicly advertised and alternatives are offered, minorities will be getting less than optimal treatment for the same price. Surely, the APA strives to be able to offer care to anyone in need, and not only to white, Christian, Americans. “In an increasingly pluralistic society such as the United States it is urgent that we develop mental health services that effectively serve the needs of cultural, racial, and ethnic minorities”(Trull & Phares 76). Thus, any certified clinician or therapist should be able to offer his or her services to a wide variety of cultures and ethnicities. Failing to do so may be considered discrimination and unethical. “The provision of professional services to persons of culturally diverse backgrounds by persons not competent in understanding and providing professional services to such groups shell be considered unethical”(Korman 105).
Giving little attention to the importance of cultural difference also leads to missing an important factor of cross-cultural competency for clinicians; aside from aiding clinicians in the understanding where their patient is coming from, an understanding of culture can possibly help the clinician to understand where the patient wants or needs to go. The issue is that what is considered normal or healthy is culturally subjective. “British Americans are often expected to leave home upon completing school, while Italian Americans may be expected to live near their parents. Therapy without awareness of such cultural differences may result in unethical practice and damage to the client. These differences become increasingly important as the cultural distance between therapist and client increases”(Ivey 198). Getting people of different cultural background to conform to western norms, beliefs, and social roles may harm the patients themselves, and damage their interactions with friends and family from their own cultural group. Some differences that result in cultural background have a great impact on a person’s psyche; a good example of this is the effect of individualism vs. collectivism. “For some people, especially those in industrialized western cultures, individualism prevails. Identity is pretty much self-contained…cultures native to Asia, Africa, and central and South America place a greater value on collectivism. They nurture what is called the interdependent self. Identity is defined more in relation to others”(Myers 43). The goal of clinical assessment and treatment may change greatly depending on the social orientation of the patient. The differences between the role of the individual in individualism is extremely different than that in collectivism. “Individualism is typically interpreted as complex behavior based on concern for oneself and one’s immediate family or primary group as opposed to concern for other groups or society to which on belongs. Collectivism, on the other hand, is typically interpreted as behaviors based on concerns for others and care for traditions and values. Group norms in collectivist cultures – above anything else – are likely to direct individual behavior”(Shiraev 9). An important point to make is that awareness to a patient’s cultural background does not in any way mean a stereotypical view of him or her, but rather an integrated view of the individual as a part of his or her culture. “The specifics of cultural identity theory provide a bridge to enable us to think through the still-not-obvious fact that the culturally different individual is not a stereotype, but still remains an individual”(Ivey 202).
Empathy, a main requirement in therapist-patient relationships is impaired if the clinicians works according to the what you see is what you get principle. Additional information about the patient, which may not be apparent at first glance, may be crucial for the success of treatment. “Empathy requires not only awareness and understanding of the unique individual before one, but also the broad array of cultural/historical factors that may underlie individual experiencing...empathy demands awareness of both individual and culture. Not only must the therapist be empathic with the client; the therapist must also be equally empathic with what is cultural in the client and its impact on both client and therapist”(Ivey 199).
Several solutions to the issue of cross-cultural therapy can be offered; the easiest being to eliminate all cross-cultural therapy what-so-ever; by having all Asian people treated by Asian clinicians one can assure that all goals are similar and that both patient and therapist are in mutual understanding about each other’s culture. Of course, this solution is hideous, and unacceptable; the ramifications of such a decision is cultural segregation, and is completely undesirable. Since ethnicity and culture are a social construct, categorizing patients and psychologists into groups may prove to be an impossible task. A seemingly ideal solution would be to have clinicians that specialize in specific cultures to be able to understand members of those cultures and offer them culturally competent treatment. These solution also carries with it problems of segregation and definition, and is not applicable. The other extreme of trying to ignore differences and treating all patients as equals or as members of the dominant culture has been practiced in the past an suffers all the illnesses mentioned in this paper. “Those who attempt to erase (or forget) cultural differences, who wish to create a society where otherness is nonexistent, come to be alienated…the moral condemnation of otherness is racist; of this there can be little doubt”(Ivey 198).
