Mindfulness When Counseling Multicultural Clients

Culture not only informs our lives and worldview, it also influences our perception of what it means to seek and receive mental health care. To form a genuine connection with clients from different cultural backgrounds and be fully supportive as counselors, we must be mindful, empathic, and competent. 

Xiomara A. Sosa, NCC, LPC, is a bilingual veteran who grew up in New York City as the daughter of immigrant parents. She now owns a private practice where she counsels clients from underrepresented communities and primarily works with women, BIPOC, LGBTQ+ individuals, Latinx individuals, veterans, and individuals with diverse cultural and ethnic norms.  

“A person’s cultural background greatly influences their perspective on counseling,” Sosa says. “It shapes their belief system regarding what mental health signifies and represents, and it also greatly influences their comfort level in their decisions to seek help. Family dynamics and norms differ in different cultures, and sometimes Western ideals tend to judge and demonize these dynamics in session and end up causing more harm to the client. What is appropriate and works in one culture does not translate into all cultures. Our mindfulness and cultural competency are immensely important in that regard.”  

In some cultures, traditional family hierarchies may determine who makes decisions about counseling and how other members will be involved, Sosa says, stressing the importance of respecting and supporting established familial roles. 

“In consultation, I help others understand the different family dynamics and how to be more competent when working with these communities. I am also a vocal advocate of the difference between putting yourself out there as an inclusive provider as opposed to being a provider who has lived experience. Those are two different things that we need to be crystal clear and mindful about when promoting ourselves to clients in multicultural communities.”  

To build a trusting relationship, counselors should also recognize that individuals from various cultures express their emotions differently, she says. 

“We tend to want to make the Western perspective on that the gold standard, but it is not applicable or even legitimate in other cultures. This has a direct impact on how someone communicates what they have experienced in counseling and therapy. We need to be extremely mindful that cultural practices do promote very specific ways of coping, and this can either help or disrupt the therapeutic process.” 

When determining the best approach, counselors should also be mindful of nonverbal means of cultural communication. This may include gesturing and body language, the amount of eye contact that a person makes, or how much personal space they are comfortable with. 

An open mind and willingness to learn are integral to mindfulness, Sosa says. 

“First of all, we must admit that we do not know what we do not know and ask questions to community members and not to one another in a void. We become aware by observing and learning from the professionals and others who are part of the multicultural community. Listen to us, respect our voices and our knowledge, and support us in implementing what we are telling you matters and works.”  

Culture may also influence what mindfulness means to an individual. 

“It shapes a person’s value system and social norms, and it also influences their belief system and how they interpret the concepts associated with mindfulness,” Sosa says. “For example, the term ‘being present’ can convey different things to different cultures. Some cultures have been practicing being present for centuries, and there is no need to teach them that concept. In that case, we can simply encourage and support it. Other cultures need to be introduced to it in a way that does not seem frivolous; they may have no cultural experience with that term. It’s important to become comfortable with asking them what their understanding currently is, meet them there, and work with that. It is not our job to impose or insist that our way is the only way. Different cultures focus on different parts of mindfulness based on the perspectives and priorities within their specific cultures and self-awareness, and we must work within that and not force our ways on them.”  

Stigma is prevalent among cultures and often creates barriers to care. 

“Some cultures perceive mental health care as a sign of weakness, which can lead to shame and hesitation in seeking mental health counseling and therapy. Different cultures have different family structures and decision-making norms that are often erroneously judged by someone outside of their culture and even made to sound as if there is something ‘wrong’ and there is a need to change, which can be particularly destructive.”  

Creating a safe, nonjudgmental space for multicultural clients is an element of mindfulness that can help establish and build trust, she advises. 

“Please do not use the term ‘multicultural’ lightly,” Sosa says. “If you are welcoming, that is great! But that is not the same as being culturally competent and mindful in providing services to particular clients. That can cause more harm than good. If you want to serve these communities, I strongly advocate that you seek out and hire providers who are actually members of those communities and who work on their cultural competency regularly.”  

She encourages counselors to build a network of colleagues as resources for improving mindfulness skills, competence, and advocacy. 

“Seek and find the individuals in your community already doing this work. Find local organizations doing this work and support them. They are the experts. I encourage all mental health professionals to amplify them, their work, and their voices.”  

Xiomara A. Sosa, NCC, LPC, is the owner of Summerville Women’s Mental Health Services in South Carolina and the founder and Executive Director of The X-Studio: A Mental Health Cooperative. She is also the creator, host, and Executive Producer of “The X-Podcast: Real Conversations About Mental Health.” 

**Opinions and thoughts expressed in NBCC Visions Newsletter articles belong to the interviewees and do not necessarily reflect the opinions or practices of NBCC and Affiliates.