In Chapter 19, the authors appear to come to many conclusions regarding the future of multicultural counseling theory and practice. The identification of the four major themes – cultural identity development, social oppression and advocacy, cultural diversity, and multicultural case conceptualization (Hays, Milliken, & Randall, 2014) – reveals those issues closest to the heart of multicultural counseling in general as well as pointing to serious considerations for theory and practice.
But perhaps the most significant conclusion is the authors’ application of the Dodo theory to existing counseling practices in the context of multiculturalism (Hays, Milliken, & Randall, 2014). There is some legitimacy to the notion that Western counseling methods might be considered “ineffective and culturally insensitive” (Hays, Milliken, & Randall, 2014, p. 536). Such methods very well could qualify as potentially harmful therapy (PHT) according to Davidson and Hauser (2015). They argue that there is a significant need for more integration regarding research and practice with the idea of using PHT as a framework for assessing multicultural competent therapy (Davidson & Hauser, 2015). They built on the work of Wendt, Gone, and Nagata (2015) who propose the idea that “psychotherapy may be inherently ethnocentric” which means that its use to cultures outside of those that contributed to its development is debatable (p. 1). However, the application of the Dodo theory proposes that traditional psychotherapeutic approaches should not be dismissed wholesale (Hays, Milliken, & Randall, 2014). These traditional approaches can potentially be adapted to meet multicultural counseling competency (MCC) standards (Hays, Milliken, & Randall, 2014). Hays, Milliken, and Randall (2014) also propose the notion of developing and using specific theories for specific populations. Empowerment theory “has roots in both feminist and multicultural theories,” meaning that it already offers ‘inoculation’ against the less inclusive or multicultural incompetent elements in traditional psychotherapeutic theories (Hays, Milliken, & Randall, 2014, p. 537). Relational-cultural theory, or RCT, is primarily focused on connectedness and reveals a shift “from working for clients to working with clients” (Hays, Milliken, & Randall, 2014, p. 537). This suggests that the clients would be able to help their therapists achieve cultural competence through bridging gaps between different societies within society. The benefit of RCT is that it more actively integrates the clients’ perspectives on multicultural competence in practice. The importance of the clients’ perspectives is emphasized by Hays, Milliken, and Randall (2014) as being critical to enhancing multiculturally competent care. Though the authors do not reflect on the clients’ perspectives in these terms, such perspectives have the potential to broaden the understanding of PHT and how traditional therapies can be adapted to avoid harm and incorporate or respond to the importance of a client’s culture in the assistance they seek.

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The authors also conclude that the future of multicultural counseling will require therapists to “leave the office” (Hays, Milliken, & Randall, 2014, p. 538). If care is dependent on context, the context of the office may restrict the therapist’s access to critical cultural components that can assist in the treatment of the client. Getting out of the office gives the therapist a better understanding and appreciation of the contexts related to the client’s experience which can, in turn, counter some of the PHT effects of traditional therapies.

I agree with the authors’ conclusions. I think they make salient points regarding the dangers of PHT, the application of the Dodo theory, and how current practice can and should adapt to the meet the needs of clients. Furthermore, if medical treatment can be ‘customized’ for a client’s particular cultural needs (such as diet), it only follows that mental health treatment should able to do the same, and the authors offer coherent arguments for just that. Furthermore many of their conclusions acknowledge the inherent weaknesses in existing therapies but they also offer ways in which those therapies can be enhanced or adapted to make them more appropriate for multicultural considerations. Many of their suggestions for overcoming the problems inherent in traditional therapies and research include integration of non-traditional approaches – thinking outside of the box, essentially – which shows a willingness to go beyond the ‘culture’ of traditional psychotherapy. It also reflects an acknowledgement that therapists must do a certain measure of both literal and figurative outreach in order to meet the needs of their clients. Returning briefly to the four major themes the authors identify, I think these themes reflect the reality of social experience, regardless of culture, while also acknowledging how different societies may contribute to, respond to, and be influenced by different cultural elements and therefore contribute to and influence the experience of individuals. In other words, these themes reflect both individual and collective concerns which must be considered in the context of therapy. The conclusions the authors reach, including the recommendations that emerge from those conclusions, more than adequately addresses both individual and collective concerns. Therefore, I agree with the authors’ conclusions because I believe they are well-founded AND well-rounded.

    References
  • Davidson, M. M., & Hauser, C. T. (2015). Multicultural counseling meets potentially harmful
    therapy: The complexity of bridging two discourses. The Counseling Psychologist, 43(3), 370.
  • Hays, D.G., Milliken, T.F., & Randall, J.E. (2014). Themes and future directions in multicultural
    counseling theory, ethics, practice, and research. In D.G. Hays & B.T. Erford (Eds.),
    Developing multicultural counseling competency: A systems approach (pp. 529-542). Boston: Pearson.
  • Wendt, D. C., Gone, J. P., & Nagata, D. K. (2015). Potentially harmful therapy and multicultural
    counseling bridging two disciplinary discourses. The Counseling Psychologist, 43(3), 1-25.