Feminist Counseling and Psychotherapy Approaches

Hi, this is Dr. Diane Gayheart, and this is my online lecture on feminist multicultural counseling and psychotherapy, based on my textbook, Theory and Treatment Planning in Counseling and Psychotherapy.

In this lecture, I'm going to go over some of the highlights of the key feminist and multicultural counseling approaches. Now, many people, when they hear the term feminism, they think that there's one. And actually, when you start looking at and reading the literature in the area of feminism, there are many different forms of feminist. So saying "I'm a feminist" nowadays can mean many, many different things that people take very different positions. And so, let's go through a few of the more common forms of feminism.

The first is liberal reform feminism, which really focuses primarily on increasing women's individual autonomy, self-fulfillment, and equality. So, this is some of the earlier versions of what it means to be feminist. Then there's something called radical socialist feminist, which is, you can maybe tell from the title, many people experience is more radical than the first, which really focuses on increasing awareness of all forms of oppression and there's an emphasis on really affecting social change. Then you also have cultural/interpersonal forms of feminism, which focus on constructing a unique and equally valid subculture that values relationship, cooperation, emotionality, which are values that tend to be more aligned with traditional ways of being feminine. And so, many of the many of the counseling approaches that are related to or considered feminist come from this particular brand of feminism. They're also the multicultural forms of feminism that really focus on the unique needs of ethnic minority women in Western cultures. And then finally, we have to mchale postmodern feminism that uses postmodern theories, which were discussed in the prior chapter, and looking at how gender gets constructed in relationship and and then how these translate into the realities that we all experience. And in terms of what it means to be a woman, what it means to be a man, how does this affect our relationships? And, you know, then the broader dominant social discourses around issues of gender. So you can see from this that there are quite a few different ways to be feminist, and we're going to touch on some of those as we go through this chapter.

So, what's the least you need to know about feminist counseling? The first is the focus is really on how a person's identity and relationships are affected by gender, culture, sexuality, and other types of stereotypes that create problems. And their basic premise is that humans seek and move toward connection with others, and this occurs across the lifespan. And interestingly, these ideas have been around, but in the last decade or so, there's been a lot more scientific evidence that talks about adult needs towards attachment. So even though attachment theory isn't technically part of this, there is a whole strand of research that kind of supports this premise that humans, we need to be in connection with others, and we need this across the lifespan. We need to feel connected to others, validated by others, and we need to have that type of intimate bonding that when in relationships, we feel valued and accepted the way we are. And the basic premise of feminist approach is that disconnection is really the root of all emotional distress. So that in one way or another, you're not feeling connected to people in significant enough ways, and because of this, symptoms develop.

One of the significant contributions of feminist theories to the field is this concept of growth-fostering relationships. And they consider that both the counselor and the client will personally grow from the counseling therapeutic relationship. And so there's the whole focus of the cows relationship is to promote personal growth, especially in the client, but they also recognize that there should be growth happening in the counselor as they learn from this client's unique lived experience in the world. And they identified what they call the five good things that characterize these growth-fostering relationships. So these are relationships in which the participants feel zest and energy for life. There's also a sense of self-worth that comes out of this relationship, primarily for the client, but also ideally for the counselor. Also, there is a sense of knowledge and clarity about the self, the other person, and the relationship. So both people feel clear about what's going on, safe in the relationship, and feel like they're active participants in it. There's a sense of creativity and productivity, and there's also a desire for more connection with the person without feeling helpless, clingy, or needy with the other person. And so hopefully, in your personal life, you can think of some growth-fostering relationships that you have. And those are those relationships that when you're done having an interaction, you feel revitalized, energized, you feel good about yourself, you feel good about the other person, you feel good about the relationship. And these are the relationships that give you energy and zest and excitement. And so hopefully, you have some of these that you can kind of refer to and and to maybe use that to help you understand what type of relationship feminist and multicultural counselors are trying to facilitate when they work with clients.

So next, we're going to talk briefly about the counseling process. In terms of the feminist counseling process, there are two primary things. One is creating an egalitarian counseling relationship between the counselor and the counselor. The other is a recognition and identifying sources of oppression in the client's life. And this can be due towards gender, social economic class, ethnicity, sexuality. There are actually so many ways a person is oppressed, even just being different from everyone else on its own family can it can be a source of oppression someone experiences, although they primarily focus on larger social and societal forms of oppression. But that would those are those are the two main themes that about feminist counselors look for when they're working with clients.

And the overall process, they should sound a bit familiar by this portion in the book, if you've been reading it. In order is developing an egalitarian relationship with the client, and then exploring those sources of marginalization and disconnection. So that's kind of the case conceptualization or kind of clinical assessment phase. Then fostering authenticity and empowering the client in their lives, both within the counseling relationship, usually beginning there, and then extending that out into their various other relationships or life contexts too, you know, in their life. And then finally, building better relationships and even communities. And so towards the end, there is this sense of trying to create better relationships in all parts of a person's life, and also building communities of support, especially with people who are feeling ostracized from or feeling different for whatever reason. So helping clients find ways to build those communities so they don't feel isolated, they do feel connected, and that they do have significant relationships in their life.

So next, we're going to talk about the counseling relationship, which is really key and central to the entire process in feminist and multicultural counseling. And so they put particular emphasis and attention to this element of the approach. Perhaps one of the things that most distinguishes feminist approaches to counseling and psychotherapy from others is an open discussion of power dynamics in the counseling process, especially as it relates to gender, sexuality, ethnicity, social economic class, levels of education, any way that a person may feel disempowered or marginalized. And then also looking at how though that sense of feeling marginalized is going to affect or may be playing out in the counseling relationship. And so there's this very open discussion of these types of issues.

This also extends into discussing diagnosis. And so the diagnosis process is made very clear, and it's very open, and it's a collaborative process rather than one where the counselor from a hierarchical position unilaterally makes a diagnosis. When communicating with other professionals, this is all also very openly discussed with clients, again, rather than the counselor taking a more wound-up position or having secret communications. So there are these very open discussions about what's going on in the entire process. And so the client's voice is considered part of that, and there's really a mutual exploration and mutuality in the relation in the relationship, including about how to go about resolving client issues. It's not like the counselor is just going to run off and write up their own treatment plan and kind of saying, "This is what you need to do." There is a much, it's a much more open give-and-take process where the client's views and ideas about how best to resolve issues is also taken into account.

Another unique element, I don't know if it's totally unique, but another element that they emphasize is self-disclosure. And this includes when the counselor makes mistakes, being open to correction and feedback from the client. But there's this emphasis on the counselor being a very full person, including revealing elements and personal information that may not be encouraged to be disclosed in other forms of counseling. And this is seen as a way of making the relationship egalitarian, minimizing power discrepancies between the client or the counselor and the client. And so this is how, so how and why self-disclosure is used. And again, like all forms of counseling and psychotherapy, self-disclosure is always used for the benefit, primarily of the client, not the therapist. So you should be doing your own kind of therapy, you know, in the name of being egalitarian, you know, you, you know, you need to also monitor what's appropriate and what's not appropriate to share. And ultimately, it needs to be for the ultimate benefit of the client.

There is also this two-way empathy between the counselor and the client. So that, and that means that not only is the counselor expected to be empathetic with the client, which is generally considered, you know, the norm in the psychotherapy process, but it's also encouraged in feminist approaches that they to encourage the client to learn how to have empathy for the counselor. Which sounds kind of startling, but the idea here again is that this is what's going to help the client learn how to have successful relationships outside of therapy. And so if the whole emphasis is "me, me, me, me, me, you be empathetic to me, me, me, me, me, me, me," and that that could not, in some cases, in particular, you'll find that that is an issue. And so the counselor can use the counseling relationship to promote for the client to learn to be sensitive and empathetic towards the counselor. Now, again, counselors should not be getting free therapy or having, you know, by, you know, having the client be empathetic with them, but it's more looking for opportunities to encourage that when appropriate, you know, again, within normal professional boundaries. And of course, the client and counselor, they shouldn't necessarily be changing roles because the counselor is having a bad day and so the client's got to listen to me. Of course, they're not taking it to that type of extreme, but it's also encouraging and allowing the client to have empathy for the counselor.

So a good example of this is, right now I am pregnant, and I cannot hide it from my clients. And so, you know, often, especially my female clients, when, "How are you doing? Are you still nauseous? How's that going?" Whereas some other approaches would really discourage that, a feminist approach is saying, "Now, that's healthy. That your clients are demonstrating normal, social, healthy behaviors that are going to serve them well on other relationships." So again, I try not to spend more than a minute or two on it, and I try to also check in with the women who've also had kids, how, you know, how they went and how their, you know, experience was. And so there was this mutual empathy and as we connect over that. So, and hopefully, to the counseling relationship helps repair empathetic failures in childhoods. So it helps repair the past by the counselor responding differently to hearing, for example, a story, a childhood story of, you know, trauma, whether major or minor, where the counselor can be empathetic and understanding. This can help repair and the empathetic failures from their childhood or other relationships.

There's also a high level of honesty and authenticity, authenticity in counseling, and feminist and multicultural counseling, where the counselor very much tries to be a real, down-to-earth person who is always honest and authentic, again, as is appropriate for the process. And there's also a willingness to address conflicts and differences with between the counselor and the client. So conflict is raised in a safe way to have good conflict about differences, and it could be about expectations in the relationship, whatever it might be. And the counselor allows this to happen. You know, their client says, "You know, I'm angry because you take too long to return phone calls," or whatever it might be. This is not something where the counselor kind of takes a very professional, "You've read my informed, you know, important consent statement that says, blah, blah, I've done that, blah, blah." So you don't have a legalistic response to that, but you respond to that in a very human way, a very open way that allows the client to learn how to safely and effectively handle disagreements and interpersonal relationships.

So authenticity within the counseling relationship really refers to a genuine responsiveness that keeps the, again, that keeps the needs of the client in mind. And so whatever the one, you know, the counselor is being authentic, it, it doesn't mean that they, you know, do not edit whatever comes first comes to their mind, and that's a form of being authentic. It, when being authentic, the question really goes back to, "Will this facilitate the client's growth? Will it strengthen the relationship by discussing, you know, and revealing this part of myself for being authentic in whatever way this is? Is this going to help the client grow? This is going to help our relationship?" So again, it's going to take the form of apologizing for mistakes, correcting when there is disconnection, when the client gets upset with the counselor, to be able to non-defensively engage that and to be open and negotiating that in a very down-to-earth way that hopefully enables the client to better handle such moments of disconnection in relationships outside of the session.

And the feminists have actually identified a specific code of ethics that they use to help guide them when working with clients. And this involves recognizing the impact of dominant cultural norms and discourses on clients and how this affects them in terms of how they relate to the counselor, how it relates to their experience of symptoms and psychological distress and relational distress. And considering these rather than considering all the problems as being housed within the individual themselves, him or herself. Then there's acknowledging power differences, both within the counseling relationship and also in the larger, in the client's broader social life. It also, this code of ethics also involves emphasizing that the counselor is accountable to the process, not just for clinical outcomes, but for the how the client feels about him or herself. That the counselor is responsible and accountable to make sure that the client feels heard and validated and supported in the counseling process. And then also, and again, this is somewhat different than some other approaches, that the feminist counselors really believe that professional counselors and psychotherapists are responsible for promoting social change in terms of areas of oppression and marginalization in our society. And whenever possible, counselors and psychotherapists should be promoting social change that enables people with, you know, various genders, sexualities, ethnicities, social economic class levels to feel more empowered and within the broader society.

So the other question that always comes up is the applicability of these ideas to men, both as counselors and as clients. And then this counselors would argue that yes, feminist counseling has significant applicability to men and values to men, and that a man can be a feminist as, you know, psychotherapist or counselor, and that also these ideas can be used with male clients. And some of what they look for is how men in our society also struggle in their own ways, in different ways generally than women, but looking for how men are creating meaning, shaping their identities, and looking for forms of connection as social roles change in our society, especially gender roles. Really have changed significantly over the last 50 years. And because of this fluidity, a lot of men are struggling with their identity and what society tells them they can and cannot do, who and they should and should not be. And so one of the places that feminist therapists really focus with men is helping men to reconnect and to develop meaningful, significant relationships in adulthood after they typically, in many cases, go through a boyhood in which they are socialized to be disconnected from themselves and their emotions, and really from having intimate, significant relationships. You know, there's lots of movies and jokes, you know, about, you know, how men talk about their emotions and show empathy. You know, it's something like, "You know, dude, that sucks," you know, and that's how they bond and know that their friend is there and understands, or whatever it is. And we have tons of, you know, movies and media jokes about the whole thing. But feminist counselors are saying, "Wait, wait, wait. We all need human connection. It's a real need." And we need that, you know, sense of connection in our society. Actually doesn't allow men to do that very easily or directly. And so that's some of what they focus on when working with male clients.

So next, we're going to be talking about case conceptualization from a feminist multicultural perspective. And this is going to draw on a couple of different approaches, but generally an approach that's going to help you think about looking at clients, um, from the lens of feminism and multicultural discourse. So when feminist counselors and psychotherapists meet a client, these are some of the things they're thinking about and in terms of conceptualizing the case and determining where to go next and how to be helpful.

The first and kind of one of their main mottos here is, "The person's political and the political is personal." You cannot separate these two. And what that means is that when you're looking at an individual, and especially when he or she is talking about problems in their personal life and, you know, concerns that they're having, the feminist multicultural counselor always sees those personal problems as connected to broader sociological discourses, issues, often forms of oppression and privilege, and the impact of society, just generally, on the individual. Because, you know, if you sit back and think about it, especially in our highly multimedia society, there are literally hundreds of images and messages that come to each one of us about what it means to be a, you know, beautiful enough female, sexy enough male, you know, wealthy enough, whatever it is. There's so many messages that come to us every single day that we often unconsciously or, you know, what kind of us only send me aware of how we're using these to judge ourselves, is whether or not we're good enough and whether we matter, whether we're worthy. So this is one area where feminist and multicultural counselors, when the first things they're looking for and listening for is as clients are coming in and describing what's going on in their life.

The other piece, another thing that they are very aware of is that any diagnostic label is highly political. In general, much like other postmodern counselors, they see the DSM diagnosis manual as is generally an oppressive practice. Now, all that said, that sometimes these labels can be helpful with a client understanding themselves. And what stands out for me is the diagnosis of post-traumatic stress disorder, PTSD. There are a lot of people who've been through severe trauma, like sexual abuse, who, when they learn about, you know, what's normal after trauma and what that can look like, that flashbacks, you know, nightmares, hypervigilance, all that's a pretty standard response for a lot of people, is very normalizing and helpful. But in general, going through and labeling people with diagnostic codes is something that feminists and multicultural counselors are very slow and hesitant to do because it can be another form of oppression and labeling is, "You're not good enough," for clients who, who may be feeling in other areas of their life.

Another key concept that they use is self-in-relation theory. And so this is where they, the focus is on how, or the assumption is that all of us develop our sense of self within a relationship. We don't have these totally separate identities. And that within each cond, within each relationship, or so we experience ourselves differently. So think about it, how do you experience yourself with your best friend versus your mom versus your dad versus a sibling? You know, versus how you feel in relation to a boss at work, and different bosses or different people at work. And if you begin to think about it, you're a little bit different in each one of those contexts, and each one of those relationships pulls out a different self, so to speak. And so much like other postmodern counselors, self-in-relation or cellphone relationship, they're a piece, feminist counselors are very aware of how this self really kind of expresses itself different and it's experienced differently in different related, you know, it's significant relationships. Again, I think identified at several points all over, um, so far, but just to put it here under specifically under case conceptualization.

So one of the specific things that counselors listen for is for examples of where the client was marginalized or oppressed in their life and identifying how this is related to their presenting concerns. And then another thing that they consider in terms of case conceptualization are relational images. And so these are the internal constructs and expectations of relationships that are based on early life experiences that can affect present relationships. So what you've learned early in your life, usually from your primary caretaker, such as a mother or father, these generally shape our expectations of later relationships in life. And so this is some another area that feminism multicultural counselors are sensitive to when we're working with clients and conceptualizing cases.

So another area that feminists and multicultural counselors focus on is this is considering a client's relative relational resilience. And what that means is when there is a disconnection or a rupture, which normally takes the form of conflict and we're feeling hurt in some way in a relationship, how does the client handle this? Are they able to go back and reconnect? Are able to repair empathic failures? Are they able to ask for help when needed? So that's, I mean, so we have these great, we already described these wonderful relationships with the five good things, and this is so wonderful, but the truth is, which I probably don't need to tell you, is that in real life, most relationships go through periods of where we have that great connection, and then there is some sort of disconnection that comes up, and it needs to be repaired. And the question is, is this client able to do that? How resilient are they? If you're not resilient, unfortunately, you know, your relationships aren't gonna go well because I don't think you're gonna find a human being on the planet who is this, it's gonna perfectly meet all your needs and the perfect time and every single time that you need them. There is as much as we try, there's the good enough mother, and there's also the good enough friend. So, so this is an important thing that they assess.

Along closely related to that is the concept of courage. And so is the, does the client have the courage to be vulnerable in a relationship in order to make deep connections? No, they're willing to really open up. And this first happens in the counseling relationship, and we also look for this to what extent is is happening in their personal lives. They also look for areas where the client feel like they matter, it mattering. But where does the client feel like they matter to someone? And there's this connection, and it is so important. And increasingly, even medical research is finding that we all need to feel like we have a purpose and that we're connected and that we matter in some way. And so this is one of the areas that feminist multicultural accounts are success.

And then lastly, they're looking at disconnection strategies and the central relational paradoxes. They look at how, how does a client disconnect from others when they're feeling vulnerable? And so like I said, there's always this push and pull of wanting to connect and then pulling away, either because one starts to feel too vulnerable or because one feels like the other person hasn't been there, has been supportive in some way. And so the question is, how does the client do this? You know, do they do it in an angry, hostile way? Do they do it in a quiet way? Are they aware that they're even doing it? So these sorts of things encounters consider when assessing and clients and figuring out where they, where and how to be helpful to clients.

So next, I want to talk a little bit about how feminist and multicultural counselors go about setting goals and targeting change based on this case conceptualization that they've just developed. So there are two main areas that feminist counselors target for change. One is social political awareness and empowerment. So they're helping clients to become aware of their own gender, ethnicity, social class, sexual orientation, physical characteristics, and abilities, and how they have often, even annoyingly, kind of just listened to what society and others, significant others, and their life have said about them and taking this to heart, and how this is actually creating some of their the problems that they're bringing to counseling to be addressed. And so there is this awareness piece of these issues, and so that clients more consciously choose how they define themselves and how they value themselves. And so that's a key element of the process.

The other one is the other major goal is to increase the number and quality of connections, specifically to build growth-fostering relationships and to help clients learn how to have growth-fostering relationships in their lives so that they feel supported and vital and alive, and basically so they're able to weather the ups and downs of life more effectively. So these are the two major areas of focus and feminist multicultural counseling.

So next, I want to talk a little bit about interventions that are commonly used in feminist counseling. So, so the first thing to address is just the general principle related to interventions, which is quite generously and flexibly, is that any intervention from other, any other psychotherapy or counseling approach can be used if it's adapted in a gender and culturally sensitive manner. And so in that sense, there's an integrative component, although these approaches or these interventions are always adapted for gender, cultural issues.

So gender role analysis is one of the most basic interventions. And this is where the counselor helps the client or encourages the client to examine how cultural rules about being male and female have affected the client's current distress. And so, you know, what beliefs do have about being a good woman or man? It might be related to your, the, you know, presenting problem. What ways do you see your gender stereotyping affecting you at work, at home, in your family, with your friends, with their children, in your religious community? So helping clients begin to actually identify this and link this to what's going on with the presenting problem. So, for example, oftentimes a lot of women experience forms of anxiety because they feel like there are all these things they should be and must be. And so you would be looking at where all these ideas about what the perfect woman, whether they come from, and to look at how that might be informing a woman's sensibility, their anxiety or depression, which are very commonly reported symptoms by women.

Another common intervention is called assertiveness training. And you may recall this from the chapter on cognitive behavioral therapy. And in assertiveness training, a lot of what you're doing is teaching the difference between what it means to be assertive, passive, and aggressive. So we all probably know what passive, which is attending, you know, primarily to the needs of others. We're aggressive is primarily focusing on one's own needs, or being assertive is this ability to balance those to the needs of the self from the other. So that when you respond to somebody, you're able to respectfully assert your needs while being sensitive to and aware of and honoring the other person's desires, needs, and wishes. Also, I like to help me say that, you know, assertiveness, I mean, it's pretty easy to go passive or aggressive or aggressive in one way or another when we're under stress. And then I think it takes a lot of conscious attention to develop the ability to be assertive when dealing with conflict and difficulties with other people. And so assertiveness training is frequently used to help clients, whether male or female, learn how to have more effective relationships with others because, you know, being passive is just as problematic as being aggressive. And so the assertiveness is kind of that balance that I think it takes generally takes a bit more effort at first to learn how to do that and to consciously find a way and work towards a mutually respectful relationships.

Another common intervention is self-esteem training, which again comes out of the cognitive behavioral tradition. And this is helping clients learn how to accept feelings as rational and valid, their own feelings, even if, you know, they wish they didn't have them. I'm learning to be able to be pleased with who one is, being able to identify and feel confident in one's own personal strengths and abilities, and to be learn how to be gentle with oneself in terms of, you know, accepting quote-unquote imperfections or how you don't measure up to how you think everyone else thinks you should be. And so helping clients learn how to be much more accepting and gentle with themselves, and in such a way that they feel greater sense of confidence in who they are and take more pride in who they are.

So other ways that a feminist counselors promote change is the corrective relational experiences. So having this maintaining this empathetic and mutually engaged relationship with the client helps a client to learn how to correct some of the earlier ideas about what's realistic or not to expect in a relationship and to teach them how to have more effective, more fulfilling, more engaged relationships. They also work on promoting self-empathy and bringing empathetic awareness to one's own experience, especially their negative self-statements, you know, "I shouldn't feel this way. I was a fool to do X, Y, or Z." So hoping clients learn how to develop a some preventive thing, not just for others, but also for themselves.

And then finally, social activism and justice is emphasized within the approach. And so helping clients become active in in activist groups, and also the counselor helping to advocate for clients in terms of maintaining, you know, needed services of one kind or another. And so by doing this, the clients become more empowered, they make changes that are meaningful. And so this is encouraged as part of the entire process in feminist counseling.

So I just want to say a word or two here about the evidence base, which is first, there's little specific empirical research on the specific approach itself and how it works with specific, you know, clients and such. Nonetheless, that this approach, however, is very consistent with both common factors work that really emphasizes the importance of the counseling relationship and a sense of hope. And also, as I mentioned a couple times earlier, in terms of the attachment research, in terms of the importance, even for adults, to have warm, supportive, you know, to use the feminist term, growth-enhancing, you know, relationships. And so there these are the streams of research that best support the feminist approach.

Now, as you might imagine, in terms of working with the first populations on that, this approach is well-suited for a variety of diverse populations. And the main thing, though, is that the counselor needs to be careful not to force, you know, their personal values or political agendas on clients. So even though this is a feminist multicultural approach, it is actually possible that many of these ideas tend to fall on the more liberal end of the spectrum, to have this whole process become potentially feel oppressive to someone who has much more conservative or liberal views on what a woman's role is or is or should not be or such things. So even this approach, I believe, you're not the canon, even be experienced as oppressive or offensive. And so this, I think, beautifully illustrates how difficult it is to be able and and how complicated it is to be culturally sensitive and sensitive to gender issues. Is even the feminist approach can end up not be feeling supported to people, you know, for whatever reason or another. And so again, only we're so black and white, and if you just followed X, Y, and Z, you would be a, you know, sensitive to all diverse populations. And unfortunately, it's not going to be that way. But at least this approach adds, I think, many useful concepts, no matter what approach you're working from, to think about when working with clients and their issues and how divert, how diverse factors like gender and ethnicity and social class can really be seen as related to most any problem that clients present.

So hopefully, this little lecture gave you a nice introduction to the feminist counseling and psychotherapy approaches, and you can read more about these and read about the treatment plan in the text. Wish you the best. Take care. Bye-bye.