Counseling Across Cultures

Seventh Edition



Counseling Across Cultures
Seventh Edition

Edited by

Paul B. Pedersen
Syracuse University (Emeritus); University of Hawaii (Visiting); Maastricht

School of Management
Walter J. Lonner

Western Washington University (Emeritus)
Juris G. Draguns

Pennsylvania State University (Emeritus)
Joseph E. Trimble

Western Washington University
María R. Scharrón-del Río

Brooklyn College City University of New York



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Introduction: Learning From Our “Culture Teachers”

1. Toward Effectiveness Through Empathy
2. Counseling Encounters in Multicultural Contexts: An Introduction
3. Assessment of Persons in Cross-Cultural Counseling
4. Multicultural Counseling Foundations: A Synthesis of Research Findings on Selected Topics

5. Counseling North American Indigenous Peoples
6. Counseling Asian Americans: Client and Therapist Variables
7. Counseling Persons of Black African Ancestry
8. Counseling the Latino/a From Guiding Theory to Practice: ¡Adelante!
9. Counseling Arab and Muslim Clients

10. Gender, Sexism, Heterosexism, and Privilege Across Cultures
11. Counseling the Marginalized
12. Counseling in Schools: Issues and Practice
13. Reflective Clinical Practice With People of Marginalized Sexual Identities


14. Counseling International Students in the Context of Cross-Cultural Transitions
15. Counseling Immigrants and Refugees
16. Counseling Survivors of Disaster
17. Counseling in the Context of Poverty
18. The Ecology of Acculturation: Implications for Counseling Across Cultures


19. Health Psychology and Cultural Competence
20. Well-Being and Health
21. Family Counseling and Therapy With Diverse Ethnocultural Groups
22. Religion, Spirituality, and Culture-Oriented Counseling
23. Drug and Alcohol Abuse and Health Promotion in Cross-Cultural Counseling
24. Group Dynamics in a Multicultural World

About the Editors


About the Contributors



Elder Wisdom

An elder Lakota was teaching his grandchildren about life. He said to them, “A fight is going on inside me… it is a
terrible fight and it is between two wolves.

One wolf represents fear, anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies,
false pride, superiority, and ego.

The other stands for joy, peace, love, hope, sharing, serenity, humility, kindness, benevolence, friendship, empathy,
generosity, truth, compassion, and faith.

This same fight is going on inside you, and inside every other person, too.”

The grandchildren thought about it for a minute, and then one child asked her grandfather, “Which wolf will win?”

The Elder replied simply, “The one you feed.”

The Western conception of the person as a bounded, unique, more or less integrated motivational and cognitive
universe, a dynamic center of awareness, emotion, judgment, and action, organized into a distinctive whole and set
contrastively—both against other such wholes and against social and natural background—is however incorrigible it
may seem to us, a rather peculiar idea within the context of the world’s cultures. (p. 34)

Geertz, C. (1973). The interpretation of cultures: Selected essays. New York: Basic Books.

The first peace, which is the most important, is that which comes within the souls of men when they realize their
relationship, their oneness, with the universe and all its Powers, and when they realize that at the center of the
universe dwells Wakan-Tanka, and that this center is everywhere,it is within each of us. This is the real Peace, and
the others are but reflections of this.

The second peace is that which is made between two individuals, and the third is that which is made between two
nations. But above all you should understand that there can never be peace between nations until there is first known
that true peace which… is within the souls of men. (p. 198)

Black Elk, in Neihardt, J. G. (1961). Black Elk speaks: Being the life story of the holy man of the Oglala Sioux.
Lincoln: University of Nebraska Press.

Conscientization does not consist, therefore, of a simple change of mind about reality, of a change in individual
subjectivity that leaves intact the objective context; conscientization supposes a change in people in the process of
changing their relationship with the environment, and above all, with others.

True knowledge is essentially bound with transformative social action and involves a change in the relationship
between human beings.


Martín-Baró, I., & Blanco Abarca, A. (1998). Psicología de la liberación. Madrid: Editorial Trotta.



Nearly every academic book ever published has acknowledged individuals who in some way played important
roles in the book’s development. In this book we depart from the usual custom and acknowledge those who,
on one hand, were important in organizing, editing, and producing the book, as well as those who, on the
other hand, played important roles in the lives of the five coeditors. The former can be considered general
acknowledgments that we all share. The latter are necessarily different for each of us. Thus we have agreed to
contribute individually.

In the general category we want to thank SAGE Publications for the confidence it has shown in us
throughout the years. The two key SAGE people with whom we have worked are Kassie Graves, who has
been part of this effort for many years, and her assistant, Carrie Baarnes. Although a relative newcomer to
SAGE, Carrie was a big help in the latter stages. We were flattered that Claudia Hoffman, SAGE’s director
of U.S. book production, pointedly selected Counseling Across Cultures as a book she wanted to usher through
its final copyediting and production stages. In characteristic good judgment, Claudia chose Judy Selhorst to be
copy editor for the book. It is remarkable how careful and efficient Judy was during the latter part of the
process, when it is so important to be complete and precise. Candace Harman and her crew in the graphics
department did an excellent job with the cover. Further north, on the campus of Western Washington
University, is Genavee Brown. A graduate student in the Department of Psychology and a most promising
young scholar, Genavee was “the organizer” in crucial stages. When the book is published, the first copy will
go to Paul Pedersen and the second will go to Genavee.

On the personal side, we offer the following highly individualized acknowledgments:

Paul B. Pedersen. I would like to acknowledge and to dedicate my role in the preparation of this book to
Anthony J. “Tony” Marsella, professor emeritus of the University of Hawaii. Tony was my prime teacher at so
many different levels. He was as comfortable in the village council of a Borneo community as he was, for
example, during a World Health Organization committee meeting many years ago, or as he was in his lectures
throughout his illustrious career. The classes he taught would frequently end with standing ovations by his
students. He originated the awareness, knowledge, and skill model, which became the basis of the measures
for competence within the field of multicultural counseling. Many other examples of his influence come to
mind. Most important, he has in recent years become a first-class friend and co-traveler in life’s journey. In
the metaphor of family, Tony has fathered many children among his students, his colleagues, and his other
brothers and sisters. For all that you have given, Tony, I send you my thanks.

Walter J. Lonner. Above all else I want to thank my immediate family, consisting of many people, both living
and dead. Among the living are my everything-and-then-some wife, Marilyn, and our three great children
(Jay, Alyssa, and Andrea), each of whom has two daughters with terrific spouses. The world had better watch
out for those six little dynamos. By name and current age they are Sika (14) and Brenna (11) Lonner, Sophia
(11) and Alena (8) Naviaux, and Nina (7) and Sage (4) Howards. I was blessed with great parents and two


brothers: Terry, the youngest of us, who is a beacon of honor and dependability and a jack-of-all-trades; and
George, the oldest. We grew up in beautiful and generous western Montana. George died October 8, 2012,

about midway through the work on this book. George was the family’s Don Quixote, dreaming big things and
imagining the impossible. It is he, not I, who should have been a university professor, for he would have
dazzled thousands of students with his talent of mixing fact with fantasy. The encouragement and praise that
Terry and George and the rest of my family piled upon me, through thick and thin, has always kept me going.
I also want to acknowledge the multidimensional influence that an international network of scholars has had
on my 50-plus years of trying to understand the nature of culture’s influence on everything we say, think, and
do. Part of this network consists of the many talented people, including the current slate of coeditors, who
have contributed to one or more of the seven editions of Counseling Across Cultures.

Juris G. Draguns. Throughout the seven editions of Counseling Across Cultures, I have enjoyed marvelous
support, encouragement, and understanding from my wife, Marie. We have shared 52 wonderful years, and
Marie’s love and empathy have helped me overcome whatever obstacles have stood in my way, sometimes
tangible, more often subjective. As I thought about, wrote, and edited Counseling Across Cultures, I would
temporally disappear into the book, and Marie was always there to welcome me when I reemerged from its
pages. My two children, Julie and George, were young when Counseling Across Cultures first appeared. They
grew up as the book evolved through its several transformations, and the two processes intertwined. What has
remained constant is our mutual love and my vicarious enjoyment of and pride over Julie’s and George’s
families, careers, and achievements. Thinking back on my early years, I gratefully remember my parents,
especially my mother, who instilled in me a curiosity and love of learning and protected me from the
dangerous world outside our home. It is thanks to her that I survived and was able to work toward the
realization of my version of the American Dream. And in the course of the ensuing multiple transitions I
benefited from a host of culture teachers who helped me become more empathetic and perhaps more helpful
across cultural barriers. They are too numerous to mention, but my sincerest thanks go to them all.

Joseph E. Trimble. I owe Paul Pedersen a special measure of personal gratitude and appreciation. In August
1972 Paul met with me and my wife, Molly, at a lanai in Honolulu. Over a late-morning breakfast he vividly
described his new triad theory of counseling training to underscore his strong growing interest in culture and
psychological counseling. It was a memorable occasion for the three of us. A few years later, Paul invited me
to give a symposium paper on counseling American Indians and later publish a chapter in the first edition of
Counseling Across Cultures. Molly was extremely helpful when I wrote that first chapter and continues to be
insightful and helpful in almost all of my writing activities. She has a keen eye for detail and a spirited mind
for novel concepts and ideas. Throughout the course of each of the Counseling Across Cultures editions our
three lovely and talented daughters, Genevieve, Lee Erin, and Casey Ann, have been with me when each
edition arrived home for their review and comment, and it has always been a proud moment for me when they
read their names in the acknowledgments and commented on it. Also, I am deeply grateful for all of the
people who have provided me with guidance, advice, and collaboration on the contents of the various chapters
put together for the seven editions. Thank you especially to Candace Fleming, Fred Beauvais, Pamela Jumper
Thurman, and John Gonzales.


María R. Scharrón-del Río. I am very grateful for the love, guidance, and support of mi familia. My mother,
Rosarito, and my sister Marilia housed and fed me in Puerto Rico as I was finishing the final editing process
for this book. My sister Marichi also assisted me with her commentary during this time, and my father,
Rafael, accompanied me on a couple of hour-long mental health escapades to the ocean. I am also grateful to
my partner, Yvonne, for her love, support, and understanding, and for providing a home for me in Germany
during part of my sabbatical. Many thanks also to my chosen family in New York City—Cody, Mara, Barb,
Wayne, Paul, and Flo—who helped in too many ways to count. I owe a special thanks to Joseph Trimble and
Guillermo Bernal, who have been outstanding mentors and friends since I was an undergraduate student in
the Career Opportunities in Research (NIMH-COR) program at the University of Puerto Rico. I also want
to thank Eliza Ada Dragowski for her exceptional work and support in the completion of this book. Finally,
my thanks to the wonderful group of people who provided additional guidance on the content of various
chapters of the book: Priscilla Dass-Brailsford, Stuart Chen-Hayes, Hollyce Giles, Vic Muñoz, Delida
Sánchez, and Avi Skolnik.

Paul B. Pedersen

Walter J. Lonner

Juris G. Draguns

Joseph E. Trimble

María R. Scharrón-del Río



During a lifetime of more than four score and four years, I have seen culture change before my eyes like a fast-
moving kaleidoscope. Old ways of being are replaced rapidly by new ones. Each generation upgrades its
relationships with the various environments that affect its existence. As I developed and acquired more
information about my time-and-space world, I understood the complexity of culture. In high school, I heard it
discussed in connection with geography. My teachers talked about how the natural environments in which
people live necessarily influence their ways of life. Their environments determine the kinds of homes they
build to protect themselves from outside elements. Since climates vary from one time zone to another, it is
tenable to conclude that the structures in which people live and work also differ from one part of the world to

In undergraduate school, I learned other things about culture. People in various groups often dress differently
from one another and may speak languages other than English. They often observe religious practices
different from the ones I knew. From the social science classes I took, I acquired a general understanding of
culture. After graduating from college, I spent two years in Europe. There I saw up close what my professors
had meant about people being different from one part of the world to another. I kept journals on places I
visited and people I met that confirmed the content of my professors’ lectures. Notable among my experiences
was the day I encountered Jean-Paul Sartre and his companion Simone de Beauvoir in a small Parisian café
where they were reading some of their works. When I entered graduate school at Indiana University,
understanding culture was my passion. I read as much as I could about it; I took as many sociology courses as I
could work into my academic program. I learned that there were more than a hundred definitions of culture
and that cultural theorists used a variety of concepts to highlight ideas that they deemed uniquely theirs. I
learned that culture is not only material but also immaterial. That is, there are objects in our environment that
determine the nature of our existence. There are also many things we cannot see. For example, we have values
and attitudes about everybody and everything. People interact with their surroundings. The individual’s
behavior is influenced by that of others. Culture is learned. It is experienced and internalized. This
internalization is often referred to as personality. It is conscious and unconscious, affective and cognitive,
perceptible and imperceptible, and much more.

When I became a practicing psychologist and counselor educator, I felt the need to understand the cultures of
my clients, because I soon became aware that their problems were usually related to the cultural contexts in
which they grew up and resided. By the 1960s, the civil rights movement in the United States was going full
blast. Integration was becoming a reality for African Americans who had previously lived in an apartheid-like
society. They had always lived in segregated communities and attended segregated schools. After the changes
of the 1960s, African Americans began showing up in formerly all-White classrooms and in the offices of
school counselors. The American Personnel and Guidance Association (now called the American Counseling
Association, or ACA), officially organized in 1952, soon found itself in the midst of the turmoil of a
dramatically changing society. Throughout the country, White counselors were expected to help Black clients;
Black counselors were expected to help White clients. It was out of the new clienteles and the different


cultures they represented that a new interest area emerged in the counseling profession. Paul Pedersen was

among the first educators to take the lead in helping counselors and psychologists to meet more effectively the
needs of clients who came to be referred to as culturally different. As I got to know Paul, I recognized that he
was visionary and just the right person to convene a panel of counselors, counselor educators, and
psychologists to discuss cross-cultural counseling at the 1973 convention of the American Psychological
Association in Montreal. Out of the panel presentations came the first edition of Counseling Across Cultures,
published in 1976. Becoming a classic in cross-cultural counseling, it has contributed significantly to what is
now the fastest-growing movement in counseling. I am proud to have been one of the participants on the
APA Montreal panel and a chapter contributor to the first edition of the book.

After the Montreal panel presentation, I conceptualized a model of culture designed to help counselors meet
the needs of their culturally challenging clients. I argue that most human beings are molded by five concentric
cultures: (1) universal, (2) ecological, (3) national, (4) regional, and (5) racio-ethnic. The human being is at
the core of these cultures, which are neither separate nor equal. The first and most external layer is the
universal culture, or the way of life that is determined by the physiology of the human species. People are
conceived in a given way, they consume nourishment to live, they grow into adulthood, they contribute to the
group, and they grow old and die. These and other ways of life are invariable dimensions of human existence.
During the course of the social development of the species, people learn to play a variety of roles essential for
survival. These are internalized and transmitted from one generation to another. It seems important that
counselors recognize themselves and their clients as members of this culture that is common to all humanity.
The recognition helps counselors to identify with and assist all clients, regardless of their cultural and
socioeconomic heritage.

Human existence is also shaped by the ecosystem, which is the lifeline for everybody. Climatic conditions,
indigenous vegetation, animal life, seasonal changes, and other factors determine how people interact with
nature and themselves. People who use dogsleds to go to the grocery store experience life differently from
those who need only to gather foodstuffs from the trees and plants in their backyards. Inhabitants of Arabian
deserts wear loose body coverings and headgear to protect themselves from the dangerously hot rays of the sun
and from unexpected sandstorms. The way of life that people develop in order to survive in a specific
geographical area of the world may be called the ecological culture, the second layer of culture.

The third environment that molds human beings is the national culture. It is reasonable to conceptualize a
national culture for several reasons. Most people are born into particular nations. In general, each country has
a national language, basic institutions, and a form of government, and the residents of the country have a way
of seeing the rest of the world and particular values and attitudes about themselves and their fellows.
Individuals born within the confines of a country’s borders are usually socialized to adjust to the rules and
regulations of that country. They learn to fit into the prevailing way of life. People first start learning to fit
into the national social order in the home, and they continue their socialization in school and other settings.
Although a country may contain several national subcultural groups, members of all such groups cannot
escape the influence of the overarching national culture.


A fourth influence on the lives of people is regional culture. In many countries, individuals identify not just
with the national culture but also with the cultures of specific parts of their countries. For example, Americans
who live along the U.S.–Mexico border may feel as Mexican as they do American. Many such residents speak
Spanish and enjoy the food, music, and way of life common to Mexico. Regional cultures are evident in many
African countries. In the north of Nigeria, where the country borders Niger, the Housas, one of the country’s
largest ethnic groups, straddle the border that separates the two countries, thereby causing the same regional
culture to exist in both countries.

The final layer is racio-ethnic culture. It is based on the recognition that racially or ethnically different groups
often reside in areas separate from those in which a country’s dominant racial or ethnic group live. People
inhabiting such racial or ethnic enclaves usually develop and maintain cultures that are unique to the
communities in which they live. Although citizens of and participants in the national culture, they may also
identify strongly with their racial or ethnic group and its way of life. For example, because of their slave
heritage, African Americans have developed and continue to maintain a culture that is in many ways different
from the national culture. Many institutions, such as the Black church, which dates back to slavery, contribute
to the continuation of a “Black culture” in some communities.

The fivefold concentric conception of culture indicates that people are the products of several influences over
which they have little or no control. No individual should be considered only a member of a single national,
racial, or ethnic culture. People are often simultaneously members of several cultures—they are individually
multicultural. Even so, across all cultures, people are more alike than they are different. Counselors who
recognize the commonalities that humans share are apt to be more effective in helping all clients than those
who focus on perceived cultural differences. Universal and ecological cultures unify the human group more
than regional, national, or racio-ethnic differences separate the species.

Readers who compare this seventh edition of Counseling Across Cultures with the earlier editions will be able to
appreciate how much the study of culture and counseling has evolved over the years. One thing that I notice is
how many more clienteles described as needing cross-cultural intervention exist today than in 1973. Culture is
no longer just an esoteric concept discussed in sociology classes and texts. It has now become an idea
appreciated, espoused, expanded, and exploited by most counselors and counselor educators. In graduate
school, I mentioned to my major professor an interest in writing my dissertation on a topic related to the
effect of culture on the outcomes of counseling. He discouraged me from pursuing that research topic and
added, “Everybody knows that counseling is counseling.” Feeling downhearted, I pursued a dissertation topic
more in keeping with his view of what was an appropriate research idea. However, since receiving the PhD in
1965, I have written countless articles, chapters, and books on how culture influences the counseling process.
Culture has become the linchpin of counseling throughout the world.

Having devoted my career to studying the relationship of culture and counseling, I am understandably pleased
to write the foreword to this significant contribution to the increasingly large literature on cross-cultural
counseling. The seventh edition of Counseling Across Cultures is a historical landmark. It is noteworthy because
it, along with the previous editions, provides a long view of culture and counseling as they have evolved in a


rapidly changing profession. It is evident that culture has taken on a more inclusive meaning today than it had
more than 50 years ago, when I was in graduate school. Then, some of my sociology professors talked
unabashedly about certain segments of our society being culturally “deprived” or “disadvantaged.” Being the
only African American in most of my classes, I was shocked and hurt to hear such assertions, because I had
learned in undergraduate school that everybody has a culture. I now understand that my professors were
talking about the culture of White Americans. It was their way of being, not that of most Americans of
Native, Asian, African, or Hispanic descent, or a host of other citizens who were identified with a hyphen in
their group designations to set them apart from the dominant cultural group.

Counseling has also evolved since the formation of the American Counseling Association in 1952 as the
Personnel and Guidance Association. Subsuming the National Vocational Guidance Association, the
National Association of Guidance and Counselor Trainers, the Student Personnel Association for Teacher
Education, and the American College Personnel Association, the newly formed organization extended the
work of social workers, teachers, and vocational counselors. Today, ACA consists of 20 chartered divisions
and 56 branches in the United States and abroad. The divisional membership breakdown usually reflects the
clienteles in which the various professionals specialize. Moreover, there are wide variations in how counselors
identity themselves. Some see themselves as guidance counselors similar to how most school counselors saw
themselves in the 1950s. Others consider themselves psychologists. Still others identify with psychiatrists. In
spite of the broad definitions of culture and counseling and the wide range of counselor identifications,
multiculturalism became what Paul Pedersen calls the “fourth force” in counseling. It continues to be the most
important thrust of counseling in the 21st century. This new edition of Counseling Across Cultures is, in effect,
a status report on this very important aspect of counseling. The chapters in this book were written by some of
the most outstanding counseling authorities in the United States and abroad. The information contained in
them is a godsend for graduate students, professors, and therapeutic professionals working in a variety of

Clemmont E. Vontress, PhD

Professor Emeritus of Counseling

George Washington University


Our Deepest Thanks to Paul B. Pedersen—Friend, Scholar, and

Paul Pedersen’s fervent passion about counseling across cultures began at a time when few psychologists and
mental health practitioners considered the importance of the cultural dimension in any significant way. The
inclusion and subsequently the infusion of the cultural dimension in counseling and clinical psychology
became a longtime commitment for Paul when he was a graduate student and quite possibly even …

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