THERAPIES AND MODALITIES AVAILABLE


  • INDIVIDUAL COUNSELING


Your personal concerns are important to me. Initially you will meet with me for an assessment to discuss the presenting concerns and to determine the type of services which will best meet your needs.


  • COUPLES' COUNSELING

Couples counseling is available for you and your partner/spouse.


  • ​ONLINE - WEB THERAPY


I offer web-based therapy and telephone consultations for people who cannot come to me. Consult with me to identify personal concerns and to find the appropriate resources in your area.

  • SESSION FEES


Individual Therapy Session (50 minutes) – $150
Couples Therapy Session (  60 minutes) – $175


  • PAYMENT


Payment in full is due upon receipt of a monthly invoice.  You may pay with cash, check or PayPal.

For extenuating circumstances I may consider a sliding fee scale.

The hourly fee applies to additional time in telephone consultations that exceed 15 minutes, and consultations in other settings (outside of supervision). Payment is expected at the time of service, unless we have agreed to alternative arrangements. Please inform me of any special financial needs you may have.

  • INSURANCE


I do not bill insurance directly. If you plan to use your insurance, you must submit a copy of the statement to your insurance company seeking reimbursement to yourself. Regardless of your insurance company’s policies, you are responsible for full payment of fees.  I am more than glad to write you a receipt for services rendered.


  • CANCELLATION POLICY


Please remember to cancel or reschedule an appointment 24 hours in advance; otherwise, you will be charged for the full rate for any missed session. Your insurance company will not pay for missed appointments.





The Westernization of Psychology


The current counseling/therapeutic methods and techniques were originally developed by European and Anglo-American theorists and practitioners based on a Eurocentric, individualistic and misogynistic model designed especially for a Western population. These methods assume the client is the product of a Western culture and holds an individualistic Euro-American worldview rather than a holistic and collectivist worldview. Whereas in Western and individualistic cultures, the individual is considered the most important member of a nuclear family and of the society in which s/he resides,  in collectivistic cultures, extended families, whether Western or non-Western ( Asian, African, Arab, etc.) all the members of the family or society are considered equally important. In therapy, this is very important because the internal/external locus of control or personal control over one’s fate and accountability are factors in the worldview of the client.

Counseling

With the passing of the Immigration and Nationality Act in 1965, and subsequent legislation, removing nationality-based quotas and allowing family reunifications, the immigration patterns seen in previous generations changed dramatically, narrowing the incoming immigrant population to Asians and Latin Americans rather than the traditional Europeans. Based on this phenomenon, today, it is not uncommon for clients and therapists to come from different cultures and share different worldviews. This idiosyncrasy requires modification in the therapeutic interaction so it encompasses a cross-cultural approach, which in itself is rather challenging for any therapist.

Cross-Cultural counseling/therapy seeks to emphasize the importance of adapting the client’s culture, values and context in the therapeutic modality. This becomes particularly important when the client is experiencing a crisis and cannot make the necessary cultural adjustments needed to facilitate a successful understanding of needs. Human beings are complex creatures, and along with being part of a culture they also live within a subculture; therefore, cross-cultural therapists work across subcultures within cultures. You may have noticed that you identify with a particular group or interest group whether it is political, religious or sexual orientation, homeless, etc., these affiliations make you part of a subculture.

The current and prevalent view among mental health practitioners is understanding that the origin of psychological problems are often rooted in the socio-cultural context of the client and it is important to understand this to understand the mindset of the client.

In Western society, communication is the key in the counseling session with the client doing the majority of the talking. This is not the norm for all cultures and if the client is not talking we assume that that person is not wanting to reveal something or is sabotaging the therapy session. In Cross-Cultural counseling when a client comes with a crisis, the therapist has to be cautious when listening to the client describe the points of concern.

Culture-Bound Issues in Current Psychology

In cross-cultural counseling, the counselor needs to be informed of the usual treatment  used in the client’s culture for the presenting problem. Another factor taken into consideration is the client’s level of acculturation to his/her host culture. The client’s levels of acculturation, years of residency in the host country, as well as language fluency, present a different diagnostic profile than one where these variables are not a factor.

Culture-bound syndromes or folk illnesses are exaggerated changes in behavior that may not syndromes at all, but the local culture’s ways of explaining the individual’s current condition.  Due to variety of culture-bound syndromes, no single type of diagnostic or therapeutic approach can be used. Therapy for some patients is a totally alien concept because their behaviors as seen by their cultures are eccentricities not needing western traditional treatments.

According to Charles C. Hughes, there are almost 200 folk illnesses considered culture-bound syndromes (Simons and Hughes, 1986). Some theorists classify culture-bound disorders or syndromes into areas affected, eg., genital shrinking (koro/suo-yang), semen loss (dhat) learned dissociation (latah  and amok),  acculturative stress (Brain fag, Bouffee-delirante) distress (susto/espanto, nervios,hwa-byung, ataque de nervios) physical appearance (taijin-kyofu reactions) environmental conditions (arctic hysteria -pibloktoq, Windigo psychosis. Bipolar disorder, low intellectual functioning, major depression and schizophrenia could also be considered culture-bound syndromes despite their particular diagnosis not conforming to an illness meeting the DSM-IV diagnoses. Furthermore, depression and anxiety are two conditions that have different meanings and severity depending on the culture of origin. According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) culture can influence symptoms and experiences of depression.

The goal of therapy is to improve or ameliorate the client’s suffering, therefore it is always necessary to consider the physiology, cultural beliefs, practices, religion and  social situation of the client, and then determine whether the presenting condition should be treated as a western malady using evidenced based therapies, or simply refer the client to non-traditional modalities which may include shamanic or folk healing, just as in Western psychotherapies, a combination of several modalities are often used. Additionally, when an assortment of unfamiliar symptoms are present, it is wise to ask family members and concerned individuals what they believe is going on in the client’s life, prior treatments or cures that have been used and what community leaders, mental health practitioner and/or healers have determined, advised or concluded regarding the client’s situation. In such cases inclusive therapies that include culture-specific and Western modalities are more likely to prove successful.

References:

Berry, J. W., Poortinga, Y. H., & Pandey, J. (Eds.). (1997). Handbook of cross-cultural psychology. Boston: Allyn & Bacon.

Culture-Bound Syndromes: Folk Illnesses of Psychiatric and Anthropological Interest (1984) Simons, Ronald C., Hughes, C.C. (Eds.) Springer, Netherlands

Herskovits, M. J. (1948). Man and his works: The science of cultural anthropology. New York: Knopf.

Jahoda, G. (1986). A cross-cultural perspective on developmental psychology. International Journal of Behavior and Development, 9, 417—137.

Matsumoto, D. (Ed.). (2001). Handbook of culture and psychology. New York: Oxford University Press.

Pedersen, P. B. (2000). A handbook for developing multicultural awareness. Alexandria, VA: American Counseling Association.

Ratner, C. (2002). Cultural psychology: Theory and method. New York: Plenum.

Rothbaum, F., Weisz, J., Pott, M., Miyake, K., & Morelli, G. (2000). Attachment and culture: Security in the United States and Japan. American Psychologist, 55, 1093-1104.

Segall, M. H., Lonner, W. J., & Berry, J. W. (1998). Cross-cultural psychology as a scholarly discipline. American Psychologist, 53, 1101-1110.

Shiraev, E., & Levy, D. (2004). Cross-cultural psychology: Critical thinking and contemporary applications (2nd ed.). Boston: Pearson.




Mancinelli & Associates

 

                                      Cross-Cultural Counseling