April 3rd, 2017, Ottawa                      written by Maria Chiru, MA in Counselling Psychology

Last week, while attending a presentation on “Working with Resistant, Unmotivated, or Mandated Clients” by the famous Dr. Scott Miller of the International Centre for Clinical Excellence of Chicago, I found myself (together with other one hundred participants) watching a case of a Latina mother, considered to be a resistant client by the US’s Child Protection Services, when in fact she was a widow raising her child alone, with limited income and no support from anyone. But the social service workers failed to understand the challenges this mother was facing (very low paid employment, English language barriers, lack of support as she was a single mom) and instead of providing the support that she needed, the workers ended up pathologizing this mother and  her child. Obviously she was not a resistant client; the social workers were just showcasing their cultural limitations in her case, which prompted me to write this article on cultural limitations to person-centred approach.

According to Wressle and Samuelsson (2004), the biggest barrier to person-centred therapy is counsellor’s incomplete set of skills and one could see how in cross-cultural counselling that would be amplified; counselling the culturally different could also present the danger of misinterpretation of specific norms and traditions, which would interfere with counsellor’s ability to create congruence. The therapist needs to achieve cross-cultural expertise and maintain a permanent mental flexibility towards clients’ cultures as some issues of delicate social context and different  lifestyle norms could escape the understanding of (even) the very cross-culturally educated counsellor (Dyche, & Zayas, 2001); therefore working towards constantly improving cross-cultural expertise, could minimise the barriers and ensure a more empathic and ethical service for the culturally different clients (Lee, 2008; Sigelman, & Rider, 2012).         

Another significant barrier to client-centred therapy is client’s level of acculturation (Sharkey, Sander, & Jimerson, 2010); creating congruence and showing empathy and unconditional positive regard, while at the same time teaching a client that some of his/her behaviours are unacceptable in Western cultures, could be very challenging, as the behaviour could be acceptable in client’s native culture, and after all, culture is a significant determinant of individuality and personality; in this case, client centred therapy would include the consideration of appropriately suitable and culture-specific counselling options (Gardiner, 2005; Gannam, n.d.). In addition, the core conditions identified by Rogers may be difficult to translate in operational terms in different/other cultures, especially for research purposes. The hypothesized innate drive towards self-actualization and the emphasis on an internal locus of control may carry a Western individualistic bias that conflicts with more collectivistic cultures and the emphasis on the exploration of feelings and emotions may make the process difficult for some types of clients.  MacDougal (2002) suggests that the ‘democratic’ client centred-approach is not the solution for all clients, while Waxer (1998) goes as far as stating that more directive approaches are appreciated by some (Asian) clients.



Dyche, L., & Zayas, L. H. (2001). Cross-cultural empathy and training the contemporary psychotherapist.Clinical Social Work Journal. 29(3), 245-258. Retrieved from http://link.springer.com/article/10.1023%2FA%3A1010407728614?LI=true

Gannam, V. (n.d.). The need for cross-cultural awareness. Retrieved from http://www.problemgambling.ca/EN/ResourcesForProfessionals/Pages/TheNeedforCrossCulturalAwareness.aspx

Gardiner, S. (2005). The search for balance: the acculturation process of Asian American graduate students and the role of therapy in the reconciliation of related concerns. Retrieved from http://www.smcm.edu/psyc/_assets/documents/SMP/Showcase/0506-SGardiner.pdf

Lee, C. C. (2008). Elements of culturally competent counselling. American Counseling Association Professional Counseling Digest. 24(1), 1-2. Retrieved from http://counselingoutfitters.com/vistas/ACAPCD/ACAPCD-24.pdf

MacDougal, C. (2002). Rogers’s person-centered approach: consideration for use in multicultural counselling. Journal of Humanistic Psychology. 42(2), 248-265. doi: 10.1177/0022167802422005 

Sharkey, J. D., Sander, J. B., & Jimerson, S. R. (2010). Acculturation and mental health:Response to a culturally-centered delinquency intervention. Journal of Criminal Justice. 10(36), 1-8. Retrieved from http://education.ucsb.edu/sharkey/documents/Sharkeyetal_Acculturation_onlinepub.pdf

Sigelman, C. K., & Rider, E. A. (2012). Life-span human development ( 7th ed.). Belmont CA: Wadsworth, Cengage Learning.

Waxer, P. (1987). Cantonese versus Canadian evaluation of non-directive therapy.Canadian Journal of Counselling and Psychotherapy. 23(3), 263-272. Retrieved from http://cjc-rcc.ucalgary.ca/cjc/index.php/rcc/article/view/1254/1136

Wressle, E., & Samuelsson, K. (2004). Barriers and bridges to client-centred occupational therapy in Sweden. Scandinavian Journal of Occupational Therapy. 11(1), 12-16. doi: 10.1080/11038120410019135