Counselling, culture and communication for change

ABSTRACT

The contemporary landscape of mental health services is changing rapidly with a proliferation of training programmes in counseling and psychotherapy based primarily on North American/Eurocentric theories and cultures. With culture acting as an interpretive frame for behavior and given the multicultural nature of Caribbean society, there is therefore the need for a culturally relevant review of therapeutic communication if practitioners are to successfully engage Caribbean people in the therapeutic process. This chapter addresses some of the cultural factors in the Caribbean which influence this communication process, particularly, how people engage or avoid engaging in the process of counseling and therapy, and suggests strategies and skills for facilitating the needed engagement. Issues examined include clients' past experiences of helping relationships, belief about how change occurs, expectations of counseling/psychotherapy as providing a "quick fix", expectations that the therapist will play a primarily didactic role and that they will be passive learners, the impact of religious beliefs on clients' decisions whether or not to seek help and the challenges of dual relationships (circumstances whereby the therapist and the client interact with each other outside of the therapy context). Concepts are based on a series of presentations made at case conferences at the University Counselling Service at the UWI, Mona, and the authors' thirty-odd years of experience in various clinical settings. The University Counselling Service provides counseling and psychotherapy to a diverse range of clients within the university community, inclusive of students, staff at all levels, faculty members and administrators.