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Power and responsibility in therapy: integrating feminism and multiculturalism.

The integration of feminist and multicultural approaches to psychotherapy, called for many times, has not yet materialized. This article reviews possible reasons this integration has not taken place and offers an approach to integration based on the guiding principles of power and responsibility, which builds on previous theories and approaches.

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As theories of counseling and psychotherapy continue to expand and develop, there has been a growing emphasis on the contextual aspects of an individual's life. Although many theories and approaches to therapy focus on intrapsychic concerns, more and more attention is being paid to the environmental factors important in an individual's world, problems, and coping resources. Two primary examples of this focus on external context and on individual differences can be found in theories of feminism and multiculturalism. In the 1980s, feminist theorists gained momentum in their questioning the approach of psychotherapists with regard to gender, gender socialization, and gender discrimination (Brodsky & Hare-Mustin, 1980; Rosewater & Walker, 1985). More recently, multicultural counseling theories have generated an enormous amount of attention and research, focusing our attention on a diversity of issues (e.g., sexual orientation, age, abilities) with a primary focus on racial/ethnic experiences (Ponterotto, Casas, Suzuki, & Alexander, 1995; Sue, Ivey, & Pedersen, 1996). At the turn of a century and beginning of a new millennium, the question rising to the foreground of counseling and psychotherapy theory is "Can feminism and multiculturalism be integrated?"

When we first set out to explore this question, our initial reaction was that integration made a great deal of sense given that the two approaches have many similarities. Specifically, both feminism and multiculturalism have helped counselors become more aware of the external factors impacting their clients' lives (Enns, 1997; Sue et al., 1996). For example, both feminist and multicultural approaches focus on the greater context of a person's life (e.g., social, cultural, economic, familial, political contexts) rather than purely on a person's intrapsychic conflicts and concerns. Feminist and multicultural counseling approaches also emphasize collaboration between the counselor and the client. Because both approaches acknowledge the potential impact of oppression on the therapeutic relationship, they both call for a greater level of communication and understanding between therapist and client. Finally, both feminism and multiculturalism share a commitment to the need for social change (Brown, 1994; Greene, 1994). Because both theoretical approaches acknowledge that many of the symptoms manifested in clients in fact represent greater ills in society, they also acknowledge that individual change is not enough. One should not have to adjust to a maladjusted system, and thus broader social change is called for. This is at the heart of the feminist motto "The personal is political."

Because of the similarities between feminism and multiculturalism, there have been several calls for integration as well as concern that this integration has not materialized. One of the most vocal proponents for this integration has come from Brown (1994), who stated that a multicultural base should be a requirement of therapy, specifically feminist therapy. However, she also noted that "while any feminist theory should reflect all forms of human diversity, this standard has rarely been met" (Brown, 1994, p. 69), emphasizing that this ideal of integration has not truly been realized. Although her discussion of best practice feminist therapy relies heavily on the analysis of culture and group status, she also cautioned that multicultural knowledge "can too easily become an undigested lump that is never integrated into feminist therapy theory" (p. 63). She cautioned that a true integration of feminist and multicultural approaches to psychotherapy will require radical change, prompting us to continually question what is normative and to constantly promote greater awareness of self and society.

Despite such powerful and persuasive arguments for integration and attention to diversity in the literature, theories of feminism and multiculturalism have been criticized for their lack of integration or reliance on a diversity of opinions. For example, feminism has been criticized for being overly focused on the needs of White, heterosexual, middle class women (Cole, 1986; Greene, 1995) and for being too "slow to extend its own insight to sociocultural factors other than gender" (Espin, 1994, p. 274). Women of color, in particular, have noted that feminism as it has existed to date has tended to downplay the importance of race and ethnicity in the lives of women. Greene (1994) noted that gender is not necessarily the primary oppression for all women and that feminism often "overlooks the privileged status of being White" (p. 336). Greene also called for the convergence of other variables (e.g., gender, race, sexual orientation) within the feminist approaches.

Greene (1994) is not alone in her commentary about the need for greater diversity within feminist approaches to psychotherapy. Johnson et al. (1997) noted that diversity should be a "necessary component of feminist practice" (p. 213), and Enns (1997) called for diversity to be a "central and defining characteristic of feminist therapy" (p. 249). Although such calls for diversity have been important, they have also been vague. It is often difficult to know exactly how feminist therapists should incorporate diversity into their work. There exists little in the way of guidance for how to implement these very critical calls for diversity and integration.

Multicultural approaches to therapy have battled similar criticisms. Specifically, multicultural approaches to counseling have been criticized for not embracing gender other than in peripheral or stereotypic ways (Arredondo, Psalti, & Cella, 1993; Davenport & Yurich, 1991). However, within multicultural counseling approaches, diversity and inclusion remain theoretically important. For example, Rhodes and Johnson (1997) cautioned that "race and class are not just additional sources of oppression but rather their interaction with gender significantly changes the experience of gender itself" (p. 30). Just as with feminist therapy, calls to integrate issues of gender with race/ethnicity also have been insufficient with regard to practical implementation. In acknowledging the importance of being enriched by diversity concepts, Hill and Ballou (1998) have suggested that the next step is a more refined articulation of the 'how to' of therapeutic practice.

Thus, both feminism and multicultural approaches to counseling have been criticized for being exclusive, for ignoring other pertinent social variables, and for being myopic with regard to the intricacies of personal identity. The continued calls for greater integration have led some theorists to propose specific approaches that connect feminist and multicultural counseling theories. For example, Raja (1998) has suggested adopting a Culture-sensitive Feminist Therapy approach, in which counselors and therapists are more aware of stereotypes, racism, and the ways cultural issues can impact a client's behaviors. Similarly, Christensen (199.5) proposed the adoption of Anti-racist Feminist Therapy, again based primarily in feminist dialogue with an added focus on racial identity. Christensen emphasized the importance of reaching a stage of awareness where one can fluidly incorporate different aspects of one's identity, such as one's feminist and anti-racist commitments. In contrast, Fukuyama (1990) began with a multicultural grounding and proposed ways to incorporate other aspects of culture (e.g., sex, age, sexual orientation, socioeconomic status) into an understanding of the term multiculturalism. She emphasized the need for a more universalist approach, which she called Transcultural Therapy.

Comas-Diaz (1994) also proposed an integrative approach to feminism and multiculturalism, one that was developed specifically for women of color. She noted that there is already a movement toward integration in psychotherapy theory and practice in general (Goldfried & Castonguay, 1992), reflected in the increasingly popular use of eclectic orientations (Norcross & Goldfried, 1992), and that the integration of feminism and multiculturalism will be an important step in empowering women of color. Yet Comas-Diaz's model focuses on only one broad group (women of color) and does not include clients belonging to other, perhaps more privileged, groups, an important criticism of approaches that focus on culture and societal power (e.g., Bowen, Bahrick, & Enns, 1991).

All of these approaches share in common the goal of successfully integrating issues of gender (brought to the therapy arena primarily by feminist psychotherapists) and race/ethnicity (primarily highlighted by multicultural counseling theorists). We admire the approaches that these theorists have taken and acknowledge that they are still relatively new to the literature. However, we find ourselves questioning why, with such eloquent arguments and powerful sentiments, the integration of these approaches has not taken hold as much as we might expect or hope to see. Why has the integration, which most will say is important, not happened in actual counseling practice? The purpose of this article is to suggest several reasons why feminist and multicultural integration has not yet occurred and to propose an approach that builds on the common principles of feminism and multiculturalism.

barriers to integration

There are several potential reasons that approaches to integrate feminism and multiculturalism have not gained momentum. First, we must acknowledge that researchers, theorists, and practitioners in the counseling field (ourselves included) benefit from privilege. Although many would agree to the principles of feminist and multicultural theories, actively letting go of either gender or racial privilege is a more difficult task. In the spirit of both feminist and multicultural traditions (e.g., Casas & Mann, 1996; Fine, 1992), in beginning to write this article we attempted to become aware of and clarify our biases. As White, well-educated, upper-middle class women, we needed to acknowledge that we do still benefit from White privilege as well as from the privilege that comes with economic status and educational opportunities. Although there is discomfort with considering this issue, we acknowledge that it is one of the barriers to the successful integration of feminist and multicultural approaches. Are feminists and multiculturalists ready to both let go of privileged status and to share in the acknowledgment of different kinds of oppression? We need to consider the various kinds of privilege that keep us from doing this, such as being young, White, male, heterosexual, educated or from an economically advantaged background (or any combination thereof). Although we hope so, we acknowledge the difficulties inherent in working to overcome such deeply rooted resistances.

Second, there have been internal battles within feminism and multiculturalism that may have prevented integration with an outside theoretical approach. For example, Sue, Bingham, Porche-Burke, and Vasquez (1999) in their report on the first National Multicultural Conference and Summit acknowledged that even within the multicultural community there is still great variation in the definition of multiculturalism. Some theorists have taken a more inclusive approach (including gender, sexual orientation, age, disability, etc.); however, others argue that to broaden the definition of multiculturalism beyond race/ethnicity will dilute the effectiveness of the theory. Some theorists have expressed concern that the more inclusive use of the term multiculturalism might minimize or obscure the importance of racial variables in the therapeutic process (e.g., Helms, 1994; Helms & Richardson, 1997), while others have argued for the importance of considering the existence of multiple oppressions that often span beyond racial identity issues (e.g., Myers et al., 1991; Speight, Myers, Cox, & Highlen, 1991). Some have addressed these concerns by attempting to distinguish between the term multiculturalism and the more broadly conceptualized term diversity (Arredondo & Toporek, 1996). The state of the field is such that there is still no general agreement on the actual scope of the term multiculturalism.

Similarly, there are tensions within the feminist community that may limit the progression of integrationist approaches. Alleyne (1998) noted that African-American women remain reluctant to take on the label 'feminist' at all (sometimes preferring the term womanist), suggesting that feminism remains important mostly to White women. Ironically, there are similar problems with the use of the feminist label even within mainstream feminism; not only is there an often confusing and conflicting variety of feminist labels from which to choose (e.g., liberal, radical, socialist, cultural), there are many whose therapeutic practices could be called feminist but who do not use the label at all to describe themselves or their therapeutic orientations (Juntunen, Atkinson, Reyes, & Gutierrez, 1994). In addition to the reluctance to even use the term feminist, Dambrot and Reep (1993) criticized feminist therapy approaches for the lack of a unifying theory, the leaderless nature of the approach, and the continued focus on White, upper middle class women. Finally, Morrow and Hawxhurst (1998) noted that there has been a recent de-emphasis on political analysis in feminist therapy. The idea that mainstream feminist therapists have rejected the original feminist call to arms of political change (and may thus be compromising core radical feminist principles) may have resulted in a splintering off of feminist camps. Without a solid mission, shared amongst both mainstream and radical groups, feminism may not be in a position to merge further with an outside force such as multiculturalism.

A third potential reason that the integrationist approach to feminism and multiculturalism has not gained popularity may be that both feminism and multiculturalism are seen as outsiders to traditional psychotherapeutic approaches. For example, despite Pedersen's (1991) claim that multiculturalism is the "fourth force" in psychology, after psychoanalysis, behaviorism, and humanism, Leong and Santiago-Rivera (1999) have noted that multiculturalism is still relatively unknown and unused in the broader psychological community. Arredondo et al. (1993) have warned that approaches that highlight gender and race/ethnicity are seen as specialized approaches, rather than necessary for all therapies. Despite the fact that every individual who comes to therapy can claim both a gender and a racial/ethnic background, approaches emphasizing the importance of gender socialization and cultural heritage are seen as additional after-thoughts in the more traditional approaches (e.g., psychodynamic, person-centered, and cognitive-behavioral). The idea that both feminist and multicultural approaches should be 'added on' to one's main therapeutic orientation suggests that many will not do the work to learn these 'additional' approaches.

Similarly, when individuals and theorists have attempted to add together feminist and multicultural tenets, there is often an awkwardness, a sense that one is mixing oil and water. Thus, a fourth reason that such an integration may have been ineffective is that the 'add and stir' approach has not worked. Just as Hill and Ballou (1998) noted that "feminist therapy is not traditional therapy with gender awareness added" (p. 5), neither is an integrationist therapy just the adding together of feminism and multiculturalism. As Espin and Gawelek (1992) stated, "to 'add women of color and stir' will not produce an integrated theory" (p. 104).

If integrating feminist and multicultural approaches to counseling and psychotherapy has not yet worked, and yet many agree that such an integration is important in the abstract, it will be important to not only consider the barriers to this integration but also examine the underlying constructs that connect feminism and multiculturalism. An approach is needed that does not presume to fit existing theories together as one, an approach that allows us to apply the tenets of feminism and multiculturalism to all clients, all people. Thus, we propose a set of guiding principles built on feminist and multicultural beliefs, where issues of power and responsibility are considered regardless of a client's race, gender, sexual orientation, etc. Because feminist and multicultural approaches share an awareness of the disenfranchisement experienced by those without power, access, and opportunity, we highlight the importance of considering power and social responsibility as core constructs for all counseling. We must first empower individuals but we must also help individuals learn to share power and to use it responsibly. Therefore, we propose a cluster of guiding therapeutic principles, based on power and responsibility (PAR) and built on previous works in feminism and multiculturalism, that focuses on acknowledging the power one has, investigating the power one does not have, and seeking to empower individuals to live more satisfying and productive lives.

guiding principles of power and responsibility

The first guiding principle for therapy is that power and social responsibility should be core constructs in all counseling. Although these are clearly not new concepts (see Brown, 1994; Hawxhurst & Morrow, 1984; Lee, 1991), we feel that they need to be re-emphasized, especially in terms of their connection to both feminist and multicultural theories. Embedded in this principle is the belief that a person's experience with power is a key influence on psychological development. The experience of being oppressed clearly impacts what a person learns about the self and the way the world works. The same is true about the experience of being privileged. An oppressive culture harms everyone who experiences it. All people who live in an oppressive culture experience negative psychological effects (Myers et al., 1991). Obviously, those who are oppressed experience the pain of limited opportunity. However, it is important to understand that those who are privileged also experience negative psychological consequences as well. For example, Thompson and Neville (1999) have pointed out that White individuals' mental health has been negatively affected by racism because their sense of identity may be based on a false perception of an idealized history and innate sense of superiority. Further, it is not psychologically healthy to ignore the advantages with which one is born, nor is it healthy to consciously or unconsciously benefit by the oppression of others. A culture in which power is abused creates a context for psychological harm at the societal level. By addressing this important issue, counselors can help privileged clients develop greater social responsibility.

An important component of this first core principle is that a person can learn to respond to his or her experience with power in healthy and responsible ways and that this is necessary for psychological health. In other words, therapy should be used to empower clients (McWhirter, 1991; Rappaport, 1981; Solomon, 1987; Worell & Remer, 1992). Empowerment involves not only understanding power and the effects of one's sociocultural experiences, but also the attainment of power and advocacy for others (Hawxhurst & Morrow, 1984). For example, it is important for a person who is oppressed to understand that the reason he or she is hurting may be connected to social, cultural, or historical factors (rather than purely intrapsychic factors) and that he or she can find ways to be empowered in an imperfect world. Additionally, it is important for a person who has benefited by the oppression of others, whether directly or indirectly, to recognize that privilege and gain a commitment to social equality for all. Thus, Brown (1994) stated that the purpose of therapy "is not to soothe, but to disrupt; not to adjust, but to empower" (p. 29).

The second guiding principle for therapy is that culture and context (one's position in relation to power in society) are powerful forces that shape psychological development (Espin & Gawalek, 1992; Ridley, Li, & Hill, 1998; Sue & Sue, 1999). Experiences in our families and in our culture teach us who we are and how to be in the world. We learn from our cultural experiences what it means to be male or female, for example, and about how to connect to the world around us. For example, learning about autonomy vs. responsibility to a group is a cultural experience that can be a key part of a person's psychological development. It is important to recognize that all people participate in culture(s) and each person's cultural experience has validity. No culture is better or worse than another (Ahia, 1984). For example, there is nothing inherently better about autonomy, self-determination, individualism, and rationalism (values typically associated with Western cultures) than connectedness and interdependence (values typically associated with Eastern cultures). Either can be both adaptive and maladaptive, depending on the context.

The third principle is that one's response to psychological pain, like physical pain, can be adaptive; it can tell a person that something in the environment needs to change. Pain can be adaptive and can protect a person from more serious injury. It is our assumption that symptoms can be used as fuel for growth and change; this is grounded in both feminism and multiculturalism. Further, Sue and Sue (1999) pointed out that examining a client's behavior from a multicultural perspective can help us understand how those behaviors are functional. A behavior that may appear to be maladaptive when viewed through traditional Western psychotherapy lenses may be very adaptive when seen in the context of the culture that created it. For example, Ridley (1995) has pointed out that cultural paranoia can be a healthy reaction to racism. Being suspicious can be a reasonable and adaptive response to living under oppressive conditions. It may help an individual to be aware sooner of a harmful action so that he or she can take protective measures. Therapy guided by this principle includes a consultative relationship in which the meaning, function, and message of the symptoms are explored. The goal of therapy is assumed to be change, rather than adjustment to oppression or maintaining the status quo (Brown, 1994; Ivey, 1995).

The fourth principle suggests that the person who sits before us is a capable, strong person who is currently experiencing a difficulty, an approach that Super (1955) referred to as a focus on hygiology or health. It is important to focus on environmental issues and how they impact psychological well-being and not to assume that a person in distress has something intrapsychically wrong. Behaviors and patterns that may appear maladaptive may actually be responses to a harmful environment. The client may need to change his or her response, however the locus of the problem is assumed to be the environment. The counselor's role is to consult with that person and help him or her understand the individual and social changes indicated by his or her pain. Finally, it is important to note that not only is the client seen as a capable consultant in the therapy process, his or her experience of power, whether that is about gender, race, sexual orientation, economic status, ethnicity or ability, is to be actively valued.

The fifth guiding principle for therapy that reflects the values inherent in feminist and multicultural approaches to psychotherapy holds that individual change is necessary but not sufficient; a complete view of psychotherapy also holds as a goal the ideal of social change (Brown, 1994; Lee, 1998) or, more specifically, liberation from oppression (Comas-Diaz, 1994; Freire, 1970; Ivey, 1995). In other words, therapists should, in addition to focusing on the unique needs of their clients, always be looking for ways to broaden a client's perspective to include the greater social good. Although this broader perspective may not be possible with every client (e.g., clients having extreme difficulty coping at the personal level) or at all moments of therapy (e.g., social change is more likely an outgrowth of a client's personal development and therefore may be taken up toward to end of counseling), we suggest that social change is a goal toward which therapists should always strive, both for the benefit of the individual client and for the broader social good. We suggest that, in addition to clients being guided to explore the experience of power in their lives and the importance of social responsibility, therapy go one step further and help clients implement changes in relation to social wellness and responsibility. For example, a female client who has worked hard to extricate herself from an abusive partnership might then volunteer at a shelter helping other women gain economic independence. A counterexample would be her former partner who through the process of therapy discovers how being male has afforded him privilege and power, which he had been abusing; he then begins working with other recovering batterers to end violence against women. These are only two examples of how social change might begin, from both the perspective of empowerment and from the perspective of social responsibility.

summary and conclusions

We have outlined an approach to counseling that is based on the principles of power and responsibility (PAR) and that is founded on feminist and multicultural approaches to counseling. We firmly believe that the integration of feminist and multicultural approaches to therapy is a valuable goal. It is also crucial to acknowledge that we believe that the perspectives of feminism and multiculturalism are uniquely very important; they have each revolutionized the current practice of psychotherapy. We are indebted to the thinkers and practitioners who first raised the issues surrounding power, equality, cultural importance, and social relevance.

It is, however, out of our respect for these approaches that our frustration with the lack of integration grew. In order to take further steps toward this integration, we suggest an approach that not only builds on the similarities between feminism and multiculturalism (the guiding principles) but one that also steps outside of the political and cultural forces that cause us to label ourselves as feminists and multiculturalists in very separate ways. We suggest that the guiding principles we have proposed be used in all counseling, not just in special cases (e.g., when working with women, people of color, gay/ lesbian/bisexual individuals, or people from any minority group). As Speight et al. (1991) stated: "The ability to work with another individual who by definition is a separate and distinct entity is a basic counseling skill, not reserved only for those who choose to specialize in multicultural counseling" (p. 30). We concur and suggest that power is an important connection among all people, whether one has it or has been denied it.

Despite our excitement about the potential of the guiding principles we detailed, we are also aware that there are some cautions about their application. Most notably, the construct of power has traditionally been defined in Western masculine terms; for this reason, it is essential that clients and therapists are clear about what power and empowerment mean for the client. For example, it would be an error to assume that empowerment always means making independent decisions and acting upon them. For a client from a collectivistic culture, empowerment may mean feeling good about the ways he or she is able to contribute to group or family well-being. Additionally, the concept of empowerment may also be viewed by some cultures as individualistic and may be at odds with the belief systems of clients and therapists from more collectivistic cultures.

The most important point we hoped to make, however, was to point out the inefficiency in the current approach of attempting to blend currently existing theories. Despite the ground-breaking work of both feminist and multicultural theorists, a full synthesis has not been reached. This synthesis in clinical work is indisputably our goal. Thus, we feel that we owe it to our clients to consider applying the principles of power and responsibility in all counseling situations. Perhaps then we will feel that the true integration of feminist and multicultural principles has taken hold.

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Elizabeth Null Williams, the Department of Psychology, St. Mary's College of Maryland. Jill S. Barber, the Counseling Center, Georgia Institute of Technology. The authors express their appreciation to Madonna Constantine and Ruperto Perez for reading drafts of the article and providing comments. Correspondence concerning this article should be addressed to Elizabeth Null Williams, Department of Psychology, St. Mary's College of Maryland, 18952 E. Fisher Rd., St. Mary's City, MD 20686, email: enwilliams@smcm.edu.
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Author:Williams, Elizabeth Nutt; Barber, Jill S.
Publication:Journal of Multicultural Counseling and Development
Date:Dec 1, 2004
Words:5659
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