Joseph M. Cervantes
California State University, Fullerton
Contact regarding this
manuscript should be made with Joseph M. Cervantes, Department of
Counseling, California State University, Fullerton, Tel (714)
Submitted to Counseling and Values
This article examines roles that gender, culture and spirituality
play in elements of therapeutic process. It presents an initial
literature review on gender, culture and spirituality as these
factors relate to shaping identities and defining one's behavior.
Discussions on how these three dimensions influence the level of
understanding and effective responsiveness that competent,
counseling professionals need to consider in a culturally and
spiritually diverse society are presented. Three case studies
provide a frame of reference designed to illuminate the complexity
that professionals are faced with when counseling issues are viewed
through one's unique gender, cultural and spiritual worldview.
Implications for counselors and the counseling field are provided.
Understanding Gender and Culture within the Context of
Spirituality: Implications for Counselors
Although significant developments in
gender, multicultural, and spiritual/religious research have further
defined professional competencies, the impact of globalization and
subsequent cultural/ethnic diversity have had a growing influence on
professional practice which necessitates a broader base of
understanding of human development. There exists a paucity of
research for how gender, culture and spirituality intersect and
impact intervention and treatment used by counseling professionals (McGoldrick,
1998). In today's global society, consequences of not attending to
these salient contextual dimensions may limit the level of
understanding for counseling professionals to assist their clients
and may even thwart their growth and development (Boyd-Franklin &
Lockwood, 1999; Cervantes & Parham, 2005; Comas-Díaz & Greene, 1994;
Fukuyama & Funderburk, 2001).
This article asserts the position of an intricate connection between
gender, culture, and spirituality which influences the therapeutic
process, and is crucial to competent therapeutic assessment and
intervention. Understanding gender and cultural differences within
the context of spiritual/religious issues has implications for
counseling theory, training for counselors and over-all
effectiveness of practicing mental health professionals (Fukuyama &
Sevig, 1999). Undoubtedly, issues regarding spirituality and
religion surface in relation to life events such as religious
differences in intimate relationships, deciding on how to raise
children, illness and pain, death and dying and learning to live
more congruently to one's values. A primary theme offered in this
writing is that gender, culture, and spirituality form a significant
backdrop to a counselor's efforts to assist an individual through
the healing process more completely.
issues have been left in the domain of spiritual leaders or quickly
referred to those practitioners who are known to do faith-based
counseling or ‘Christian counseling' (Ellis, 1986; Shafranske,
1996). Adequacy of a counselor's understanding regarding the scope
of religious conflicts and client's cultural differences are now
questioned (Bergin, 1991; Taylor, 2000; Warwick, 2002).
A relevant study conducted by O'Connor and Vandenberg (2005)
investigating religious beliefs among mental health professionals in
their randomly assigned case vignettes demonstrates a level of
confusion about how counselors evaluate a client's religion and
spirituality in counseling practice. This study implies a lack of
conceptual and professional awareness that may provide a critical
link to informing and influencing effective responsiveness for
counseling professionals with their clients. In addition, is there a
more comprehensive and holistic approach to understanding the larger
framework of an individual's psychological complaints? Answering
this question may be at the helm of a more sophisticated counseling
approach that begs consideration in today's society. Arnett (2002)
and Giddens (2000) noted that diversity is shaping and creating
multitextured personal and social identities which underscore the
observation that we are becoming bicultural, multicultural, and
Gender role socialization and cultural experiences shape identities
of women and men, define their behavior, and set up expectations for
how they interact in the world (Davenport & Yurich, 1991). Gender
role behaviors change between various cultural groups; however,
significant themes reflect commonalities across cultures. For
example, among many cultural groups, female roles typically reflect
caretaking responsibilities while male roles focus on status at
work, in relationships and in society. Gender role behaviors may be
influenced by spiritual/religious experiences. Spirituality/religion
contributes to women's development and men's identity. How men and
women view themselves in relationship to the world around them is
critical information for counselors to examine (Gilligan, 1991;
A critical variable for men and women is reflected in their
relatedness to spirituality or religious practices.
Spirituality/religion is a part of one's cultural milieu and informs
meaning, value and direction of human issues (Miller, 1995;
Pargament, 1997; Shafranske & Malony, 1990). Accordingly, one's
self-perceptions, worldview and identifiable behaviors are
significantly influenced by gender, culture and spirituality, and
require practicing therapists to develop a more integrated
understanding of how these salient factors shape client behavior.
Using these three dimensions to guide therapeutic understanding and
intervention suggests an expanded approach and knowledge base to
counseling that may be more inclusive and therapeutically respectful
to an increasingly diverse population. Further, these dimensions
will likely affect the manner in which inquiry is asked of a client
and how one's human story unfolds. To examine solely psychological
symptoms and complaints as the primary dimension in counseling
process disregards the complexity of professional practice now
evident (Fukuyama & Funderburk, 2001; Hays, 2001; Stanard, Sandhu, &
This article provides a brief literature review on gender, cultural
diversity and spirituality. Three case studies are used to analyze
implications for counseling professionals and their increasingly
diverse clientele. Additionally, this article initiates an
exploration of the interplay between gender, culture, and
spirituality as it impacts therapeutic practice and scope of the
counseling professional. Development of a conceptual base for this
integration is an important step toward understanding how the
psychology of globalization influences multiple identities and
co-occurring psychological symptomology and related behavioral
Multidimensionality of Gender
Cultural diversity embodies a number of factors that individuals
bring to therapy and gender is a dimension that plays a critical
role. The importance of sex and gender as significant variables to
consider in counseling process goes largely undisputed. It has been
long recognized that men and women reflect various differences as
mental health consumers and presenting issues. The work and research
of many authors (Daniluk, Stein, & Bockus, 1995; Dupuy, Ritchie &
Cook, 1994[MR2]; Maxey, McCullough, Rachal, & Worthington, 1997) has
enlightened the mental health profession regarding consequences of
not attending to sex differences and gender issues in the training
of mental health professionals. For example, several professional
organizations address the issue of inclusivity of women's issues and
sex differences. The American Psychological Association's ethical
principles (1992) were revised to echo the unethical nature of
sexist practices in, not only education, but research and
therapeutic treatment. Additionally, the American Counseling
Association's Ethical Standards include nonsexist practice along
with The Council for Accreditation of Counseling and Related
Educational Programs (CACREP). CACREP reflects specific mandates in
gender training for their counselors (Dupuy, Ritchie & Cook, 1994).
Clientele of most mental health professionals reflect primarily
women. Consequently, a clearer understanding of women's issues is
suggested, and is an arena that is receiving increased awareness in
training programs (Zimmerman & Haddock, 2001).
Stevens-Smith (1995) asserted that differences exist between men and
women based upon decades of research and documentation. Men and
women perceive, process, and behave differently and regardless if
those experiences are inherent or learned, gender is one way
individuals frame their world and society at large. Stevens-Smith
pointed out that a counselor's belief about gender impacts his/her
approach when working with men and women, regardless of sexual
orientation, and employs counselors to examine their own worldview,
not only as a cultural being, but as a gendered being. Understanding
human development from a gender perspective is an important
conceptual window to consider in order to provide accurate
assessments and treatment approaches.
Murray Scher and Glenn Good (1990) pointed out that gender and
counseling in this twenty-first century will require counseling
professionals to understand gender's impact on the way in which
society is defined, organized and functions. Gender related belief
systems may inform therapeutic decisions and behavior during
counseling if gender schemas are salient for a counselor. For
example, display of emotions may play an important role for many
male counselors. However, if gender notions are not as essential to
a counselor's self-concept, one might choose different therapeutic
interventions and behaviors (Maxey, McCullough, Rachal, &
Worthington, 1997). Scher and Good (1990) asserted that ignoring the
impact of conceptions of gender in professional work is an
invitation to disaster and poor therapeutic outcome.
Woven through the social context of gender role assignments and life
experiences is the spiritual/religious realm. Although there is a
significant literature base in pastoral counseling, there are
limited studies and academic discourse related to the intersection
of religious counseling and gender (Hickson & Phelps, 1997; Warwick,
2002). Discussions of gender role proscription and socialization are
salient to understanding how an individual views oneself relative to
spirituality and culture. Maxey, McCullough, Rachal, & Worthington,
(1997) asserted that religious differences between women and men may
echo cultural stereotypes. The authors' research suggested that in
many cultures and religions, women were more religious than men.
Writing by Guenther (1992) underscores the importance of
understanding how men and women differ with respect to their
religious and spiritual awareness and co-related behavior.
Consequently, potential clients may perceive a female counselor as
more spiritually/religiously aware and sensitive to providing
effective therapeutic interventions than a male counterpart.
Case study: Kafta. Kafta is a 32-year-old Middle Eastern female. She
sought therapy because she was unhappy with many aspects of her
life, especially her home life with her family. Kafta's mother died
2 years earlier from cancer and being the only female among four
sibling brothers, she had full responsibility of the domestic chores
in the house. Her culture dictated that she remain living at home
until marriage. Kafta was a college student who was born and raised
in the United States and felt as if she related more to Western
values than her Middle Eastern upbringing. However, Kafta's values
were in conflict with her father's who expected her to marry someone
he chose for her after she graduated from college. Kafta had a
secret involvement with a Caucasian man she met at a dance club. She
articulated that she was tired of living a lie and was beginning to
experience a great deal of anxiety and self-doubt about her future.
Her anxiety was increasing as her graduation date neared. She
reported feeling pressure to remain faithful to her family's
religious beliefs (Muslim) and acquiesce to her father's wishes for
her future. However, her exposure to Western individualism gave her
options she wanted to keep open.
As a female in a Middle Eastern family, Kafta was expected to wait
on her sibling brothers and father and leave all decision making up
to the men in the family. Kafta felt conflicted between wanting
independence and leaving the safe and secure comfort of her home and
her family's protection.
This case exemplifies the importance of considering the intersection
of gender, culture, and religious orientation. While not all Middle
Eastern families ascribe to a Muslim religious belief system,
Kafta's family did. Kafta's dilemma of wanting to both individuate
from her family and yet remain under their "protection," appears
developmentally appropriate from a Western perspective, apart from
her age. However, given her cultural and religious history and
gender, Kafta's dilemma had far reaching consequences to her sense
of well-being and her family relationships. Having sensitivity and
awareness regarding Middle Eastern values and Kafta's personal
family background, it would be important not to impose and apply
Western values to treatment and intervention strategies. Critical to
fostering a safe and healing environment for Kafta, would suggest
giving her the opportunity to describe the unique differences and
conflict of values that existed in her family. In addition, the
context of Kafta's religious traditions impacted life decisions that
she had been socialized to consider.
Following a year of counseling by the first author (SP)[MR4], Kafta
entered the differentiation phase of development when her brothers
moved out of their home and her father remarried. Kafta began to see
her gender and cultural socialization expanding as she chose to make
different decisions for her future. She started to develop a more
enhanced sense of self-determination and reevaluate familiar ways of
being in relationships with family members and significant others.
Failure to incorporate an understanding of this client's Middle
Eastern psychological framework from which gender, culture and
religious beliefs played prominent roles, could likely have caused
emotional harm. It is interesting to speculate how counseling may
have differed if this client's family system had not changed,
namely, if the strong male influence remained intact.
Religion and Spirituality
Therapeutic problems may surface when one's life is faced with
events and difficulties that lead one to existential dilemmas and
examination of the human condition. The search for one's place in
the larger collective has been found in religion and spirituality
for many diverse communities and cultures (Walsh, 1999; Garrett &
Wilbur, 1999). Exploring the meaning behind a painful event or
coming to terms with an existential crisis taps into the domain of
spirituality and religion that often need further understanding by
the counseling profession. Lukoff, Lu, & Turner, (1995) assert that
the spiritual/religious dimensions of life reflect some of the most
significant cultural aspects framing human experience. Belief system
and values tend to be incorporated within a continuum of the
cultural and spiritual/religious backdrop. (Lukoff, Lu, Turner,
1995). According to Stanard, Sandhu, & Painter (2000), treating
various medical and psychological conditions may require that the
assessment of one's spirituality be considered. They suggest that
the impact of spirituality has resurged and is becoming a salient
and dynamic force in counseling and psychology. Cervantes and Parham
(2005) recently commented that religious/spiritual dimensions tend
to prominently frame life experiences for people of color.
America's religious history has changed dramatically over the years
as communities have become more diverse with respect to culture,
ethnicity, values and traditions. From a sociological perspective,
religion has remained a constant in mainstream society and belief in
God reflects the attitudes of 95% of this country's population
(Greeley, 1989[MR6]). However, the spiritual essence of people has
become more impactful and can be found in writings of popular books,
headlined topics of motivational speakers, new age thinking, and
scholarly writings (Constantine, Lewis, Conner, & Sanchez, 2000;
Musgrave, Allen, & Allen, 2002; Stanard, Sandhu, Painter, 2000;
Prest & Keller, 1993; Miller, 1995; Perlstein, 2001; Shafranske,
1996; Puhakka, 2001; Krippner, 1995; Faiver, Ingersoll, O'Brien, &
McNally, 2001; Simoni, Martone & Kerwin, 2002; Weiner, 2001[MR7]).
It is important to make a distinction between various
interpretations of religion and spirituality. Most definitions of
religion reflect specific social, denominational, and behavioral
characteristics that involve group membership as part of a system of
worship, whereas, spirituality reflects a more individual experience
in search of meaning and value in life and a desire for a
relationship with something that is transcendent (Walters & Bennett,
2000; Fukuyama & Sevig, 1999). However, spirituality and religion
are interconnected as they reflect a sense of meaning and purpose
and both assist in bridging a relationship to mystical aspects of
human experience (Lu, Lukoff, & Turner, 1995).
It is beyond the scope of this article to provide a detailed review
of the numerous, worldwide variations of religion. A useful source
is Wilber (1999) who promotes an understanding of religion and
spirituality that organizes a hierarchy of mind, body and spirit.
This organization supports a link between gender, culture, and
religion/spirituality, and prompts a recognition that this framework
can significantly enhance an understanding of an individual's
personal, social, and community identity.
Integrating a dialogue that views religious and spiritual concerns
as potentially salient with clients, suggests that counselors become
competent relative to inquiry in this area. Many culturally diverse
female clients can present their psychological complaints wrapped in
the influence of their spiritual/religious experiences (Ansley,
Rose, & Westefeld, 2001; Comas-Diaz & Greene, 1994; Musgrave, Allen,
& Allen, 2002; Thomas, 2001). In Kafta's case example, her Middle
Eastern upbringing, culture and religious sensitivity influenced her
to enter a process of decision-making that respected Middle Eastern
values and her psychological position. Kafta's gender played a
critical role in her process of individuating at a pace that became
acceptable and less-threatening. However, if in the process of
unveiling a client's psychological complaints, the counselor makes a
gender-based stereotype about one's spiritual/religious orientation,
the process and outcome could be adversely affected.
Additional writing about the role of spirituality and
socio-emotional well-being is noted by Musgrave, Allen & Allen,
(2002) who discuss the importance of cultural framework and its
influence in the religious/spiritual experiences of women of color.
For example, some Chicano/Latino populations frame the meaning of
health and disease as including spiritual, moral, physiological,
social and metaphysical dimensions which are viewed as gifts or
punishments from God (Cervantes & Ramirez, 1992; Falicov, 1995).
Gender and cultural considerations for some African Americans
further reveal that Black women regard prayer and belief in God as
preventive health measures. Consequently, African Americans are more
likely to involve themselves in church activities and opportunities
for prayer (Boyd-Franklin & Lockwood, 1999; Parham, White, & Ajamu,
2000). Comas-Diaz (1994) has commented that spirituality for people
of color assumes a pivotal role and provides a source of personal
strength. Their ability to, not only endure, but transform their
experiences came from a religious belief that God was with them
throughout their struggles (Collins, 1991).
Historically, religious and spiritual concerns have been relegated
to the back burner for the mental health professional who was more
likely not to address them, and not facilitate a discussion about
any related themes that may cross over into a psychological and
counseling arena. As a result of globalization, the
religious/spiritual narrative has become a major dimension to
understanding diversity among individuals. Some typical ethical
dilemmas in counseling may include: navigating a difference in
values within a couple or among family members that may impact
religious issues, being responsive to varied cultural and ethnic
diversity of peoples and the overlay with the psychological
complaint, following the outcome of major traumas such as accidents,
natural disasters, and difficult life events, to name a few. Many
cultural groups, both within mainstream America and immigrants who
come may hold mainstream religious beliefs as well as various
combinations of indigenous spiritual beliefs that comprise their
human experience. Failure to assess these various belief systems in
a systematic way could lead counselors into an unexamined
psychological arena that is loaded with various ethical dilemmas and
value discrepancies that may impact both assessment and treatment
for clients or the respective families.
Overview of Cultural Diversity
Understanding culture and the counseling relationship has evolved
significantly since Sue's review (1988) of psychotherapy for people
of color. Identifying cultural ideology, language and a conceptual
framework took several decades. As a result, it culminated in a more
critical appreciation for how culture frames professional
relationships (Arredondo, 1999; Carter, 1995; Parham, White, & Ajamu,
1999; Sue, Arrendo, & McDavis, 1992), service delivery (Falicov,
1995; Paniagua, 1998; American Psychological Association,
2003[MR8]), and the philosophical anchoring of this integration
relative to culture, context, and counseling (Betancourt & Lopez,
1993; Espin, 1997; Hall, 2001; Parham, 1989; Sue, 1988).
The history of multicultural counseling spans several decades. The
1970s initiated discussions about how mainstream psychology did not
attend to concerns of people of color. Subsequently, a surge of
research examined the counseling process and its impact on race (Ponterotto,
Casas, Suzuki, & Alexander, 1995). According to Sue and Sue (1999),
the voice of minority group authors continues to criticize the
mental health profession for its inability to meet diverse needs of
the culturally different, such as counselor insensitivity and
limited knowledge base, biased assessments and treatment strategies
and unacknowledged awareness of values and belief differences. These
observations continue in spite of the wide availability of
counseling guidelines and standards that have been developing over
the past decade (American Psychological Association, 1993; 2000;
2003; Arredondo, 1999; Sue, Arredondo, & McDavis, 1992).
Multiple Identities and Culture
Multicultural research in the past decade, has advocated for the
inclusivity of other contextual identities in addition to culture
and ethnicity. Gender, ethnicity, religion, sexual orientation, age,
and disability are considered relevant parameters in assisting the
counselor to provide effective counseling techniques and approaches
(Hansen, Greene, & Pepitone-Arreola-Rockwell, 2000; Hays, 2001).
Robinson and Howard-Hamilton (2000) affirmed that attention to the
intersection of gender, culture, class, and race is salient to
understanding that psychosocial identities embody each of those
constructs and determines one's psychological framework. These
authors warned against allowing one identity construct to define an
individual's character. They also revealed that making assumptions
based upon a monocultural perspective, a view that diminishes an
individual's personal and social reality, is potentially unethical
practice and could cause psychological harm.
Richardson and Molinaro (1996) reaffirmed what many prior writers
have stated, namely, that becoming aware of one's own worldview and
culture is a necessary precondition for escaping ethnocentrism.
Overcoming one's own biases and prejudices recycles the old adage,
"Counselor know thyself." The authors stated that counselors who
develop accurate assumptions and appropriate attitudes concerning
recognition of potential contextual backgrounds with clients is the
higher level competency that should be achieved. They assert that
this competence must include an assessment of religious and
spiritual practices and beliefs as a mean to validate a more
comprehensive view of clients' experience.
The concept of multiple identities in understanding human experience
still needs a more lucid, conceptual home. Richardson and Molinaro
(1996) have started to lay such a foundation by articulating the
salience of religion and spiritual beliefs in counseling
relationships, but also in viewing these parameters as diverse as
This conceptual linkage of gender, culture and spirituality has been
further developed by Swartz-Kulstad and Martin (1999). These authors
stated that to understand cultural journeys of diverse populations,
counselors must understand individual experience from the client's
ethnocultural and contextual reality, namely, considering
interactive and dynamic aspects of emic (individual), etic
(universal), and group level variables. Swartz-Kulstad and Martin
(1999) described the Cultural and Contextual Guide (CCG) process as
an attempt at this integration.
The CCG provides a method for therapists to consider culture and
context in their diagnostic and treatment practices through
assessment of five contextual cultural factors: cultural
orientation, family environment, community environment,
communication style and language. Community environment can provide
a spiritual/religious social network that exerts a positive
influence over an individual's mental health. The authors emphasized
that without recognition that individuals experience their cultural
worlds in unique ways, and without assessments and interventions to
assess those differences, counselors compromise their ability to
construct a solid framework for understanding the impact of culture,
gender, and spirituality on clients. As a result, the narrative
story of the client becomes fragmented, non-integrating, and a
holistic picture of the individual does not merge. The goal is to
establish an integrative narrative of clients that are intertwined
with contextual components and multiple identities that define human
The following client scenario provides an example of how Swartz-Kulstad
and Martin's (1999) conceptual framework might be utilized to
understand a client's multiple identities.
Case study: Miguel. Miguel is a twenty-two year old college student
who moved to Southern California from a small rural area in the
Philippines ten years ago, with his parents. Miguel presented at the
college mental health center with concerns related to anxiety,
isolation and depressive symptomotology over his constant struggle
to assimilate and find satisfying relationships. Miguel's situation
moved him from a traditional, collectivistic, environment to a
marginal and individualistic, cultural environment. In his home
community, Miguel enjoyed closely connected relationships with
friends and family. He reported a strong connection to his church
and religious community. Currently, Miguel reports feelings of
isolation and awkwardness in fitting in with his peers. He feels
caught between conflicting demands, values and relationships between
two dissimilar cultures. As a result, Miguel has been experiencing
severe feelings of isolation, anxiety and depression. Miguel
reported that his school experiences were fraught with mockery about
his style of relating to others. Miguel's socialization experience
in the Philippines allowed him to enjoy emotionally close and
expressive relationships with men and women. His feelings were
compounded by his future plans to continue living in the United
States in order to better provide monetary support to his extended
family in the Philippines. Even though Miguel reports feeling
strongly connected to his religious Christian values and traditions,
it brings little comfort to his feelings of isolation. From Miguel's
perspective, his future necessitates further assimilation to feel
successful, while sacrificing meaningful contacts with others.
In this case example, the discrepancy between the allegiance to his
native culture and his need to assimilate into the current
environment suggests that several issues reflecting culture, gender
and spiritual beliefs be examined. This client's contextual life
experiences contributed significantly to his complaints about
anxiety, isolation and insecurity as a Filipino male. The client
expressed feelings of security with the treating therapist (SP) and
reported that he has felt more comfortable in the company of women
since he has been living in the United States, while feeling
unsettled with men since the move.
Analyzing Miguel's situation from the Cultural and Contextual Guide
(CCG) process, suggests that an examination of his cultural
orientation, family history and cultural background can provide a
more integrative knowledge base about this individual. Miguel's
cultural background allowed for a more closely connected experience
in his relationships with family and friends. He enjoyed a
communication style that was emotionally expressive and contributed
to more meaningful relationships with community members which
included a strong connection to his religious community. In his
current Western community, Miguel experienced isolation and feelings
of anxiety as his attempt at developing relationships were
criticized and misunderstood. Miguel found that his masculinity was
As a result of feelings of disharmony, counseling focused on
Miguel's perception of being socialized male in his mother culture.
His socialization experience in the Philippines allowed him to
develop closely connected and emotionally demonstrative
relationships with men while maintaining his masculine identity.
Miguel's struggle with conflicting cultural and gender beliefs
demanded an appreciation of gender that did not compromise his sense
of manhood, yet would also help him explore these discrepancies
without personal threat. Counseling issues related to gender
and the framing of his manhood identity prompted an awareness of
gender and culture that did not compromise his already formed
perceptions as a man. Exploring the role that spirituality/religion
played in Miguel's life was critical to his assimilation process. He
was able to discover that involving himself with a
spiritual/religious community that resembled one he had left in the
Philippines created a greater sense of belonging. Again,
conceptualizing this case from a single point of cultural reality
would have missed a salient infrastructure to Miguel's previously
developed social and cultural reality.
This case analysis is illustrative of an integrated narrative that
highlights the significance of cueing in on the multiple realities
of the client. Case conceptualization that was able to interweave
the dynamic interplay between the individual and the various
contextual identities that comprised Miguel's experience of
acculturation to American society provided a more complete picture
of his life circumstances.
Alternate Models of Integration
Swartz-Kulstad and Martin's (1999) framework is one model that
assists in this integration of multiple identities with culturally
diverse populations. Other models have been proposed by Hays (2001),
Falicov (1995), Robinson and Howard-Hamilton (2000), Fukuyama &
Sevig (1999). A blending of these authors' writings about gender,
culture, and spirituality assisted in a more full understanding of
the complexities in the following case.
Case study: Jenna. Jenna Red Elk [MR9]is a 27-year-old female of
Mixed Native American and Caucasian heritage. Her parents separated
when Jenna was 4 years of age and raised primarily by her maternal
grandmother until the age of twelve. Both maternal grandmother and
natural mother are full blood Cheyenne which also resulted in their
maintaining strong tribal loyalties which included Jenna's
participation in fancy dancing at many local and national powwow
events. Jenna's life was one of idealic fantasy and continuous
emotional support in her home that was provided principally by
maternal grandmother. Natural mother reportedly had had her share of
difficulties with drugs and alcohol and problems maintaining a
stable work history. At the age of 12, Jenna's grandmother died of
cancer, and natural mother remarried leaving Jenna in care of
maternal aunt and uncle. This family change brought a significant
benchmark for Jenna who subsequently was shuffled to her paternal
grandmother at the end of seventh grade and was raised in a strict
Protestant environment where she was exposed to a Lutheran church
value system. At the age of 16, Jenna stated that she was
impregnated by a "White boyfriend" who subsequently abandoned her
resulting in paternal grandmother insisting that she now find her
own way in the world. Jenna stated that she managed to support
herself and her infant child, graduated from high school and junior
college, and subsequently enrolled herself in a four-year university
at the age of 22.
Jenna Red Elk presented herself for counseling at the age of 27 as a
result of several failed male relationships, anger at men and at
God, and still mourning the loss of her maternal grandmother.
This case proved very challenging particularly in light of the
therapist being male and this client's prior history of relationship
difficulties. In spite of recommendations to refer her to a female
therapist, Jenna stated that the personal background of the treating
therapist and second author (JMC)[MR10] coupled with his familiarity
and professional interest in indigenous ways of healing, prompted
her to remain in counseling. Nevertheless, issues of anger at males
surfaced as a significant aspect of treatment. This anger became
transformed into rage at her father for having abandoned her and
subsequently at the other males in her life who had abused her.
A second theme in this counseling was Jenna's own exploration of her
ethnic and cultural identity and her confusion about how to handle
her biracial background and the exposure to an indigenous belief
system that was at odds with contact to later Lutheran
indoctrination. Relevant for Jenna in this treatment phase was the
need to reconnect with an ethnic identity that was comfortable for
her and with a spirituality that did not compromise the teaching she
had received both from her maternal grandmother, and later from her
paternal grandmother. Following a two-year course of treatment,
Jenna became more resolved with the death of her maternal
grandmother and the anger she had felt at her father for his
abandonment. Jenna was able to reconnect with her indigenous roots,
began participating in healing rituals from her Indian background,
and initiated her own daughter, now 12 years old, into a supportive
community that had previously given her security, understanding, and
meaning in her early development.
Gender, Spirituality, and Diverse Populations
Examining how gender impacts one's spiritual or religious experience
allows counselors and clinicians to become more astute in their
assumptions, interventions, and theory building with culturally
diverse populations. As Arnett (2002) has well noted, mainstream
society is in the midst of personal and collective transformation
that is impacting beliefs, values, and identity. Relevant dialogue
proposed by Kanis (2002) about multiple identities and counseling is
supportive and validating towards the perspective advanced in this
writing. Women and men do interpret religious and spiritual
experiences differently; ethnicity and culture does impact
counseling in profound ways; gender and gender socialization is a
significant dimension in incorporating culture and spirituality.
Overt and subtle gender-specific messages have pervasive affects on
women's spirituality and religious traditions (Kanis, 2002; Hickson
& Phelps, 1997; Worthington, 1989[MR11]). Gender and cultural
experiences of each client influence the perception and
interpretation of life events, impacts one's religious and spiritual
connectedness, and is vital to assessment and treatment of a diverse
population of individuals.
A model which incorporates dimensions of gender, culture and
spirituality and invites a more sophisticated inquiry about the
client's life experience and perspective from these three areas is
in need of further development. It is not within the scope of this
article to further delineate such a model other than to propose the
need in view of a more globalized society that prompts a more
integrated and holistic understanding of ethnically diverse
communities. However, what is known is that spirituality and
religion embody multicultural values and gender experiences. The
gendered nature of human experience frames the interpretation of
most life events and influences the way in which women and men
process information (Arredondo, Anastasia & Cella, 1993; Puhakka,
2001; Kanis, 2002; Nelson, 1996; Gilligan, 1991; Stevens-Smith,
1995). Consequently, gender and culture greatly influence one's
spiritual/religious path, physical and mental well-being, supportive
relationships and coping mechanisms (Hunt, 1995; Puhakka, 2001;
Comas-Diaz & Greene, 1994; Musgrave, Allen & Allen, 2002; Pargament,
Admittedly, not all clients subscribe to a religious/spiritual
practice; however, the ability to explore religious and spiritual
development in the counseling arena, for those clients where this
connection may be salient, can provide additional coping strategies
and further develop one's self-efficacy.
Findings & Implications for the Counseling Profession
Addressing human development issues in contemporary society may
require a multidimensional frame of reference which is inclusive,
holistic and integrative. Some important implications argued in this
paper are noted in the following. First, understanding people from a
gender perspective recognizes that healthy development for women and
men reflects differences and does not necessarily mirror the Western
male model of development and individuation (Comas-Diaz & Greene,
1994; Hunt, 1995; Nelson, 1996). If counselors are not gender aware,
they risk pathologizing and misdiagnosing their clients. This
article suggests that professional practice incorporate cannot
afford to ignore a perspective that validates sensitivity and
understanding regarding an individual's unique life experiences as a
male or a female.
Second, Robinson and Howard-Hamilton (2000) warned against allowing
one identity construct to define an individual's character. This
assertion lays the foundation for the concept of multiple identities
in understanding the human experience. Multicultural research has
advocated for the inclusivity of various contextual identities
because not to examine the multiplicity of human experiences may
place the counselor in a vulnerable position of ineffectiveness
(Hay, 2001). The bi-cultural couple who seeks counseling due to
conflicting religious and cultural values may truly not be heard
without the respect, sensitivity and understanding of culture and
Third, the spiritual/religious facet of human experience echoes
cultural values. Spiritual and religious experiences have also
contributed to the healing of many existential dilemmas. Their
significance shapes and impacts human behavior and informs the
interpretation of life events for many diverse communities. Further,
use of ritual could add a relevant therapeutic advantage to the
healing process (Bewley, 1995). Without exploration of continued
research in understanding the interacting dynamic of multicultural,
gender and spiritual processes, the mental health profession may
continue to support existing blind spots and unsophisticated
Fourth, research reveals that training and education needs exist for
both graduate programs in the mental health fields, as well as for
practicing counselors and clinicians regarding current gender
constructs and developmental models, multicultural competency skills
and spiritual understanding (Hage, 2006; Zimmerman & Haddock, 2001).
The authors state that without recognition of effective assessments
and interventions to assess these relevant dimensions of human
experience, counselors may compromise their ability to understand a
more inclusive counseling framework for their clients (Hays, 2001;
Swartz-Kulstad & Martin Jr., 1999). It is significant that
counselors in practice realize that globalization has now entered
the consulting office in very dramatic ways requiring that basic
levels of expertise in recognizing relevant contextual factors of
the client be an expected level of informed competency.
Fifth, integrating a conceptual knowledge base in counseling theory
relative to religion and spirituality cannot be sufficiently
understated. A rationale has been provided in this article through
case illustration and discussion as to the relevance of this salient
dimension in the healing process. There is an anticipated awareness
in graduate counseling programs and related course work that
instruction in the spiritual lives of individuals can add a holistic
foundation to effective therapeutic work that can fortify other
areas of a client's life history (Hage, 2006; O'Connor, 2004; Young,
Cashwell, Wiggins-Frame, & Belaire, 2002).
The value of this writing desires the promotion of long-term
curriculum adjustments for graduate programs, more comprehensive
training for trainees, as well as holistic and inclusive dimensions
of relevant training for the practicing professional community.
Providing the emerging mental health counselor with a realistic set
of professional values, attitudes and skills relevant to current
societal changes and demands is underscored relative to counseling
practice. Mastering this emerging wave of globalization in
communities towards a more integrative understanding of the
individual is a salient standard of care that is expected of a
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