Psychologist Q&A: Counselling Indigenous Clients
Q. I am a non-Indigenous practitioner counselling Indigenous clients. Can I really do this effectively and what is the best way for a non-Indigenous therapist to counsel Indigenous clients?
A. Many non-Indigenous practitioners “genuinely struggle” when working with Aboriginal people. They may lack the degree of cultural competence necessary to effectively counsel Indigenous clients (i.e. issues of cultural competence may not be clearly defined) or they may be unsure how cultural issues may be applied in a therapeutic context. There are some things that a non-Indigenous person can do, however, to be more culturally-aware in order to effectively counsel Indigenous clients:
- Focus on building the relationship with the person. Stories and images may be an effective way to build the relationship and deliver important psychological information and strategies
- Have a ‘yarn’ in informal places if this makes the client feel more comfortable
- Understand that ‘boundary-setting’ may be difficult as there may be few or no personal/professional boundaries as compared with non-Indigenous clients
- Be prepared to work more flexibly, in terms of location and expected outcomes, when working with Indigenous clients
- Understand that third-person referrals are the most likely source of obtaining Indigenous clients, rather than first or second-person. Fewer Aboriginal clients are likely to self-refer than non-Indigenous clients.
- Ask Aboriginal elders and colleagues for guidance when experiencing difficulties
- Try to be respectful of the Indigenous culture at all times, including asking for permission when appropriate
Overall, recognise that Aboriginal culture is different from Western culture and as a non-Indigenous person you are likely to make mistakes. Therefore admit your failings and ask for guidance when appropriate. Also be aware that some Aboriginal people may also have a very real fear of engaging with the ‘white’ mental health system because their relatives may have been sent to mental health hospitals, away from their communities, or they may have heard negative stories about the medicines used in Western culture. When counselling an Indigenous person, issues such as these may need to be addressed in a gentle manner, preferably using a story with a positive outcome.
Psychological testing and assessment instruments
Psychological testing is an area which many non-Indigenous counsellors and therapists may find challenging. Psychologists may be unsure of what tests to use and therefore avoid psychological tests altogether, or alternatively use Western testing instruments that are not culturally appropriate or valid. Scientifically valid, culturally competent assessment instruments for Indigenous clients are available, and their use should be encouraged by both Indigenous and non-Indigenous therapists when working with Indigenous clients. Cultural competence instruments that assess practitioners’ knowledge and skills in working with Aboriginal people, for example, include Tracy Westerman’s (PhD) measures. The managing director of Indigenous Psychological Services (IPS), Tracy’s instruments measure therapists’ skills and knowledge by asking questions such as: “Am I able to engage with Aboriginal people as effectively as I am able to engage with non-Aboriginal people?” “When I work with an Aboriginal client am I able to use a range of therapeutic techniques?” (Ford, 2003)
References:
Ford, S. (2003, October). Bridging Cultures: Psychologists working with Aboriginal clients. Australian Psychological Society, InPsych, Feb, downloaded from: hyperlink.
Toula Gordillo is a Clinical Psychologist, AIPC private assessor/tutor and regular contributor for Institute Inbrief. Toula has an extensive work history as a Clinical Psychologist, Teacher, and Guidance Officer. For more information, visit www.talktoteens.com.au.
My Story Cards are a great culturally appropriate and easy to use tool. The are image based, depicting life domains (a type of Quality of Life tool). The Psych/counsellor asks the person how they would rate their life over the past week/month and think about the things that contributing to it going well and not so well. Then ask them to choose 5 cards that resonate with them. (Positively or negatively – doesn’t matter). Then asked them what each card means to them. I use a strengths based approach (what is keeping you strong/going well in this area and is there anything that could be better? eventually facilitate towards a plan). Images have an emotional connection and work well for narrative cultures. My Story Cards reduce cross cultural barriers as they are client centred and they make the session relevant (client identifies and leads from issues important to them) and they simplify communication (which is culturally loaded). Useful for any cross cultural session, young people and for low emotional literacy (works for high emotional literacy too – subjective well-being, circumstances and the person’s perceptions, thoughts, feelings, and reactions to those circumstances)