Psychotherapy Theory Paper

Feminist counseling and psychotherapy, having emerged from the Women’s Liberation Movement of the late 1960s and 1970s, would appear to be naturally situated in the social justice arena in counseling psychology. However, many of the qualities that characterized feminist therapy as it emerged from its grassroots origins (e.g., radical critique of mental health systems and psychotherapy, consciousness raising, political analysis and activism, and commitment to social transformation as integral to work with clients) have faded into the background as feminist therapy has become more mainstreamed and feminist therapists have focused increasingly on individual solutions to human problems (Marecek & Kravatz, 1998b; Morrow & Hawxhurst, 1998). In addition, for a significant period in the herstory of feminist therapy, multicultural perspectives were included unevenly and have been centralized only recently in an integrative feminist multicultural therapeutic approach (Bowman & King, 2003; Bowman et al., 2001; Brown, 1994; Comas-Díaz, 1994; Espín, 1994; Israel, 2003; Landrine, 1995). This chapter will review the evolution of feminist multicultural psychotherapy, identify theoretical underpinnings for its ongoing development, and propose a social justice agenda for feminist multicultural therapy in counseling psychology. In addition, we provide two examples from our work as feminist multicultural counselors for social justice. Psychotherapy Theory Paper

Herstory and Evolution of Feminist Multicultural Counseling

Feminist and multicultural counseling perspectives emerged from the social and political unrest of the 1960s. As disenfranchised groups began pressing for social change, counselors and other mental health professionals found themselves stranded without the tools to address cultural differences and oppression (Atkinson & Hackett, 2004). Feminist and multicultural scholars and practitioners began to criticize traditional therapies for their racist and sexist underpinnings. Mainstream psychology, particularly through the diagnostic process, pathologized women, people of color, and others for qualities and behaviors that were outside of the White, male, heterosexual norm. In addition, “symptoms” arising from victimization (e.g., battered women’s syndrome; anger or fear responses to racism, sexism, heterosexism, etc.) were often labeled as personality defects (e.g., borderline personality disorder, paranoia) instead of being understood in the context of trauma theory as a reasonable consequence of intolerable and oppressive circumstances.

Another criticism of traditional therapies was their exclusively intrapsychic focus (McLellan, 1999). McLellan also argued that traditional therapies assume that all people have equal access to choice and power and that each individual is responsible for her or his own life circumstances and unhappiness, failing to recognize the ways in which oppression limits choice and power.

The impetus for multicultural counseling came from increasing attention to cross-cultural counseling and cultural diversity emerging from ethnic and cultural movements of the 1960s and 1970s. The 1973 American Psychological Association (APA) sponsored conference on clinical psychology in Vail, Colorado, was an important turning point for the profession of psychology when it was declared unethical to provide counseling services if the provider lacked the appropriate cultural competence to do so (Korman, 1974). Multiculturalism in psychology and counseling was not easily accepted in the field given the predominantly intrapsychic focus and the view that human distress was primarily psychophysiologic in nature. In response to this resistance, Smith and Vasquez (1985), in their introduction to a

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Handbook for Social Justice in Counseling Psychology: Leadership, Vision, and Action

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special issue of The Counseling Psychologist on cross-cultural counseling, wrote the following:

We believe that the doctrine of color blindness in mental health and counseling psychology has outlived its usefulness. Therapists are not color-blind. Culture is a major factor in the life development of individuals, and ethnicity is a major form of identity formation and group identification. (p. 532)

Over the years, the multicultural competency (MCC) literature has focused on five major themes: “(a) asserting the importance of MCC; (b) characteristics, features, dimensions, and parameters of MCC; (c) MCC training and supervision; (d) assessing MCC; and (e) specialized applications of MCC” (Ridley & Kleiner, 2003, p. 5). Early training in multicultural counseling stressed the importance of knowledge, awareness, and skills in working with diverse populations; this trifold objective remains central in the training literature today. The multicultural counseling literature has moved from a focus on merely appreciating and celebrating diversity (as important a beginning as this was) to an insistence on examining the underpinnings of privilege, power, and oppression, particularly as they relate to groups of people who have been marginalized (Liu & Pope-Davis, 2003). The recent adoption by the APA (2002) of Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists was a stunning victory for the profession and provided psychologists with aspirational goals to guide their work with ethnic minority individuals. Psychotherapy Theory Paper

Feminist therapy grew out of political activism in the United States in the 1970s and was conceived of as a political act in and of itself (Mander & Rush, 1974). From its inception, feminist therapy was a response to feminist critiques of traditional therapy practices that were identified as harmful to women (Chesler, 1997). Its goals were twofold: to engage women in a process of political analysis geared to raising their awareness of how interpersonal and societal power dynamics affect their well-being, and to mobilize women to change the social structures contributing to these harmful power dynamics (Ballou & Gabalac, 1985).

The first decade of feminist therapy was characterized by “a critical examination of mental- health services to women, feminist consciousness-raising groups as an alternative to psychotherapy, an activist and grassroots orientation to therapy for women, an emphasis on groups as opposed to individual psychotherapy, and assertiveness training” (Morrow & Hawxhurst, 1998, p. 38). In the second decade, feminist therapists worked to further define feminist therapy by identifying and describing its goals, its processes, and the skills needed to practice it (Enns, 1993). Books and articles about feminist therapy proliferated during this time, as did critiques from within and outside the discipline (Morrow & Hawxhurst, 1998).

As feminist psychotherapy became increasingly mainstreamed and professionalized, radical feminist writers such as Kitzinger and Perkins (1993) sounded the alarm that feminist therapy —along with therapy in general—served a domesticating, depoliticizing function. Instead of the “personal being political,” the political was being inexorably whittled away until it was once again privatized, individualized, and personal. In a special issue of Women and Therapy (1998) on “Feminist Therapy as a Political Act,” researchers and practitioners addressed this problem in a number of ways. Hill and Ballou (1998) found that feminist therapists addressed power issues in the client-counselor relationship and helped clients examine oppression and the sociocultural causes of distress; in addition, some therapists actively worked for social change by advocating for their clients and teaching clients to advocate for themselves. However, Marecek and Kravatz (1998a, 1998b) found very little in their study of feminist Psychotherapy Theory Paper

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Handbook for Social Justice in Counseling Psychology: Leadership, Vision, and Action

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therapists that distinguished the therapists as uniquely feminist. Most of the characteristics espoused by participants in the study were characteristic of humanistic or New Age therapies (McLellan, 1999).

In addition, prominent women of color in psychology and social work spoke out, bringing to light some of the omissions that characterized the predominantly White feminist therapy movement (Comas-Díaz, 1994; Espín, 1994). These authors provided an analysis of how feminist therapy, as it existed then, was harmful to women of color and to other women who were marginalized because it ignored important dimensions of their identities and life circumstances (Brown, 1991, 1994). Women of color have historically—and justifiably—viewed feminism as ethnocentric and class-bound and have challenged the centrality of gender oppression espoused by many Euroamerican feminists (Bowman et al., 2001). Alternatively, Espín (1994) recognized the potential value that feminist therapy could have for women of color if it were to recognize ethnicity as a major component of oppression along with gender. In describing her own journey of evolution as a feminist therapist, Brown (1994) referred to her earlier practice as “monocultural” (p. 75) and articulated the importance of considering each client’s unique constellation of identity dimensions and life circumstances rather than having her or him choose one aspect of identity on which to focus in counseling. This process of self- reflection has characterized multicultural and feminist endeavors with increasing honesty and success over time.

A particular example of the ongoing integration of feminism and multiculturalism arose at a working conference of the APA Division 17 Section for the Advancement of Women (SAW), where conference organizers had been explicit in their planning for a feminist multicultural agenda of a project that was intended to result in significant scholarly contributions in a number of areas of feminist multicultural research and practice. Although organizers and working group leaders embraced the terminology of “feminist multicultural” and working groups were recruited for diversity across race/ethnicity, international status, sexual orientation, gender, and professional/student status, issues emerged surrounding whose voices were privileged. The SAW conference became a microcosm for working with issues of privilege and voice. Feelings ran high, and the ensuing months led to conversations (informally, through presentations and discussion hours at APA, and through writing and publication), most particularly about the integration of racial/ethnic multiculturalism and White feminism. Following the conference, Bowman et al. (2001) provided a particularly powerful critique questioning the “real meaning of integrating feminism and multiculturalism” (p. 780). These conversations continue to be an important venue through which feminist and multicultural scholars and practitioners move toward greater integration. This does not necessarily imply that the road is straightforward or easy. A core challenge to this integration is to resolve a multicultural commitment to respect diversity of cultural values while simultaneously holding a feminist value that women’s subservience to men is something to be overcome. The complexity of working to empower women when their cultural or religious beliefs dictate certain limits on their behavior is something that needs to be addressed continually in order to continue the dialogue.

Gradually, feminist and multicultural counseling principles and practices have been integrated into a form of therapy in which client and counselor analyze power dynamics on an interpersonal and societal level and include in this analysis the ways that the various aspects of the client’s identity and privilege (e.g., gender, race/ethnicity, sexual orientation, age, socioeconomic status, religious affiliation, ability/disability status, etc.) affect these power dynamics. Scholarship has continued to emerge in this integrated field and promises to guide feminist multicultural practice (e.g., Asch & Fine, 1992; Bowman et al., 2001; Landrine, 1995; Psychotherapy Theory Paper