by Sandra Collins, Gina Ko, Yevgen Yasynskyy, Ben Kuo, Monica Sesma, Melissa Jay, Stephanie Nardone, Brandin Glos, Mariam Mahdi, and Nada Hussein

In this first chapter, we provide an overview of some of the major influences on our positioning of counselling relationships as the central organizing construct for this ebook. We build on the brief rationale we provided in the Introduction to begin to answer the central, organizing question: In what ways can the relational practices of the counsellor and the nature of the therapeutic relationship shift, adapt, or be altered altogether in response to the specific cultural identities, contexts, values, worldviews, and needs of each individual client? It is important to point out that it is impossible for us to answer fully this question for you, precisely because of its client-centred nature. We will introduce conceptual and theoretical guidelines, invite you into a process of ongoing critical reflection about the practice of counselling, offer you an opportunity to learn new skills and techniques, and expose you to diverse voices and perspectives. However, all these elements come together only when you engage directly with each individual client, couple, family, group, or community with whom you work. It is only in the context of those lived relationships that you can come to understand more fully the nature of the relational practices that will serve clients’ unique, culturally embedded, and contextualized needs.

The creative development process of this resource was collaborative, iterative, and nonlinear. We invited feedback on our vision from students, instructors, and colleagues. That vision has also evolved over time through our own work and through the contributions of the many contributors to this ebook.

1. Relational practices. In this section of each chapter, we introduce the conceptual, theoretical, and applied practice principles that support the overall goal of centring the counselling relationship in our work with all clients. Often we complement these with applied practice examples to bring the concepts and principles to life. We position these principles and practices as foundational to the rest of the content in the chapter, because they foreground client-centred and values-based practice, which is, in turn, foundational to implementing counselling processes, microskills and techniques, and reflective practice.
2. Counselling processes. The ebook is also roughly organized to mirror some of the initial elements of the counselling process. We do not present these as steps, because counselling is a fluid and iterative process. However, we have tried to provide a meaningful flow over the course of the ebook, beginning with the process of welcoming clients in this chapter, moving through coming to a shared understanding of clients’ lived experiences, and finally setting directions for the therapeutic process. We do not address specific change processes in this ebook. Rather, our focus is on conceptualizing client lived experiences as a foundation from which to envision change.
3. Microskills and techniques. Throughout the ebook, we also introduce a set of counselling microskills and techniques that are designed to support the relational practices and counselling processes introduced in each chapter. These are accompanied by demonstration videos of various kinds to enhance your learning.
4. Reflective practice activities. It is our belief that reflective practice is foundational to responsive relationships. Reflective counsellors (a) recognize the need for self-awareness, including cultural self-awareness; (b) actively engage in critical self-reflection before, during, and after encounters with clients; (c) open themselves to feedback from clients, colleagues, and supervisors; and (d) continuously integrate that feedback to enhance their understanding of self and other.
5. Applied practice activities. In most chapters we include applied practice activities that are designed (a) for self-study, if you are accessing this resource for your own professional development, and (b) for use in counselling courses at universities or colleges. These activities require a partner, so now would be a good time to think about with whom you might work to develop your proficiency in the relational practices, microskills, and techniques introduced in those chapters.

In this first chapter, we start by grounding the importance of relationships in counselling in the professional literature to give you a sense of the background for this ebook. We then introduce you to the counselling process by discussing what it means to welcome clients into a responsive, therapeutic environment. We will wait until Chapter 2 to introduce any specific microskills and techniques. To begin the process of reflective practice, we introduce you to Macey, a client whose composite story emerged from our reflections on what we have heard and learned from our own clients and our conversations with our colleagues about their work. An overview of the chapter is provided below.

Figure 1

Chapter 1 Overview

RELATIONAL PRACTICES

In this section, we draw on the professional literature in counselling and psychology to provide a rationale for centralizing relationships in counselling practice. We begin with an examination of the common factors research that highlights the relative influence of theoretical and transtheoretical variables on counselling outcomes. This leads logically into a discussion of values-based practice, in particular the importance of the lenses of cultural responsivity and socially justice. Finally we introduce recent research on responsive relationships that ties together and builds upon the common factors, multicultural, and social justice foundations. Our intention is to ground our assertion that relationships are central to counselling practice in the historical and emergent literature in counselling and psychology.

A. Common Factors

There is now a considerable body of evidence to support the assertion that certain common factors across theoretical approaches are more significant in accounting for therapeutic outcomes than factors specific to each approach (Duncan, 2014; Feinstein et al., 2015; Nuttgens et al., 2021). These common factors are often clustered into three primary areas: client factors, counsellor factors, and relationship factors (Duncan, 2014; Feinstein et al., 2015). Later in this chapter, we review recent research on responsive relationships, which has considerable overlap with the common factors research, particularly in terms of client factors and relationship factors (Norcross & Wampold, 2018). As we strive to build a foundation for effective and culturally responsive counselling relationships in this ebook, we will attend carefully to these transtheoretical factors.

To capitalize on client factors in this ebook, we strive to honour the uniqueness of each client, tailoring the counselling process to their cultures and worldviews, ways of being in relationship, and the specific contexts of their lives (Duncan, 2014; Feinstein et al., 2015; Norcross & Wampold, 2018). We also attend carefully to building an intentionally collaborative relationship (therapeutic alliance) through which clients and counsellors work together to define therapeutic directions and to envision change in line with client-centred perspectives and needs (Duncan, 2014; Feinstein et al., 2015; Norcross & Lambert, 2018; Nuttgens et al., 2021). Through this process clients can develop a sense of expectation for change that is often associated with positive therapeutic outcomes (Norcross & Lambert, 2018; Wampold, et al., 2017). The development of an empathic bond between counsellor and client is central to the therapeutic relationship, which we argue must be grounded in mutuality and cultural responsivity (Norcross & Wampold, 2018; Nuttgens et al., 2021; Wampold, et al., 2017).

We will also address counsellor factors. Nuttgens and colleagues (2021), in review of the literature in this area, concluded that “ ‘expertise’ is more of a dynamic concept, one that involves a focus on skill improvement, lying outside of adherence to a singular theory.” We will introduce reflective practice principles and processes to support you in ongoing skill development as well as increased intentionality in your interactions with clients. Fostering intentional practice also enhances client expectancy: their hope and belief that therapeutic processes will lead to outcomes they desire (Duncan, 2014; Feinstein et al., 2015; Nuttgens et al., 2021). One final common factor that is integrated throughout this ebook is client feedback (Feinstein et al., 2015; Norcross & Wampold, 2018; Nuttgens et al., 2021), which we frame in terms of practice-based evidence later in this chapter.

Notice that counselling theories are not prioritized in this summary of the factors that influence the efficacy of counselling practice. The common factors research and the current writing on responsive relationships challenges the status of counselling theory, suggesting that the specific choice of theory is significantly less critical to the counselling process. In fact, the evidence suggest that most models of counselling are equally effective when we attend to the common factors in change (Duncan, 2014; Feinstein et al., 2015; Norcross & Wampold, 2018; Nuttgens et al., 2021). We argue that what is more important is the ability to co-construct with the client a culturally responsive shared understanding of the challenges they face and a meaningful, coherent sense of direction that offers them hope and motivates their engagement in the process.

As consumers of psychological research, it is also important to apply continuously a critical lens to assess the applicability and relevance of even well-established principles and practices to BIPOC and other nondominant populations. We will invite you frequently to look at your assumptions about counselling from multiple perspectives. As we focus on the common factor of counselling relationships, in particular, we invite you to consider the ways in which client culture and context might influence what is perceived as therapeutic and growth-fostering for each individual you encounter.

Our major focus in this ebook is on the relationship between counsellor and client, which the common factors literature reinforces as foundational to the efficacy of the therapeutic process. Further, we question the influence of the other common factors if the foundation of a therapeutic relationship is lacking. Parrow et al. (2019) introduced concept of evidence-based relationship factors, as a subset of the common factors that are “distinctly relational” (p. 330), and therefore, may not be drawn upon as part of the client–counsellor relationship in all counselling models. In this sense, they are common only to certain approaches to counselling. We will attend to the eight relationship factors they identified throughout the ebook:

• Rogers (1961, 2007) original conditions of congruence or authenticity, unconditional positive regard, expression of empathy on the part of the counsellor;
• the therapist positioning of cultural humility drawing on Davis et al., 2016 and Hook et al. 2013; 
• the working alliance, defined originally by Borden (1979) to include both sense of emotional connection as well as collaboration and consensus on therapeutic directions and processes;
  
• attention to reparation of ruptures in the client-counsellor relationship and attention to countertransference; and
• progress monitoring, which includes informal client feedback and more formalized outcomes monitoring processes.

B. Values-Based Practice

In the Introduction we positioned our thinking and writing within the constructivist paradigm, which leads us to foreground the subjective nature of knowledge, to value diversity in perspectives, and to recognize the existence of multiple realities (Gergen, 2015; Socholotiuk et al., 2016). This positioning is consistent with the emergent consensus within the professions that counselling and psychotherapy are inherently values-based practices (Collins, 2018d). We contrast this with the historical embeddedness of counselling in individualist worldviews (Audet & Paré, 2018; Collins, 2018f) that derived from a modernism or positivism paradigm. We challenge the individualist assumptions of the objectivity of the counsellor, the universality of linear views of health and healing, and the assertion that experience can be understood from a decontextualized and intrapsychic lens (Bemak & Chung, 2015; Collins, 2018f; Paré & Sutherland, 2016). Instead we invite you to recognize the ways in which you, as counsellors, are deeply embedded in the sociocultural contexts of your lived experiences, and to consider the influence of the values you hold and, therefore, those values that seep into your interactions with clients, consciously or unconsciously.

We do not believe it is possible to set aside these influences to assume a value-neutral position in counselling (Collins, 2018b). We invite you instead to examine and re-examine continuously both personal and professional values in service of your clients. In counselling, as in society as a whole, certain sociocultural narratives or cultural perspectives are given more weight than others. Dominant (i.e., individualist, colonial) discourses often have more influence on the meaning attached to various experiences, while alternate meanings are ignored, invisibilized, or inaccessible until they are brought into conscious awareness (Gergen, 2015). Values-based practice, by way of contrast, begins with personal reflection undertaken by each counsellor on the nature and source of their own deeply held values and assumptions about human nature, how problems develop, and how change occurs. It also involves individual and collective application of a critical lens to counselling theories and practices to make transparent how these may be embedded in oppressive paradigms (Ginsberg & Sinacore, 2015; Greenleaf & Williams, 2009; Mintz et al., 2009; Paré, 2013) and to look for alternative ways to approach health and healing as appropriate to each client.

This emerging consensus on the need for counsellors to engage, actively and purposefully, in values-based practice is reflected in the explicit expression of values in the codes of ethics of psychology, counselling, social work, and other helping professions (Canadian Association of Social Workers, 2005; Canadian Counselling and Psychotherapy Association, 2020; Canadian Psychological Association, 2017). Values-based practice has also come to be strongly associated with culturally responsive and socially just counselling (Collins, 2018d), because it is often in the meeting places of diverse worldviews, lived experienced, and cultural norms that values differences emerge.

1. Cultural Responsivity

What exactly is a responsive relationship from a cultural perspective? The term cultural responsivity has come to the foreground in the multicultural literature in the past decade with somewhat different meaning and intent than earlier terms, such as culturally inclusive, infused, diverse, or centred practice. Although the term responsivity is used in the literature in a variety of ways, Collins (2018f) positioned cultural responsivity as “a broad measure of the degree to which the counsellor and the counselling process are reflective of, and influenced by, the cultural identities, worldviews, and social locations of the client” (p. 918). The key implication of this term is the continuous integration of input and feedback from the client in the context of a collaborative counselling process (Collins, 2018d; Paré, 2013). In this ebook we focus specifically on the relational and conversational practices associated with culturally responsive counselling. Paré (2013) spoke of conversational responsivity as client-led dialogue that attends to the language, themes, and ways of knowing brought forward by the client through conversation. Paré and Sutherland (2016) defined relational responsiveness as attending to what is required at the microlevel of the conversational exchange, moment-by-moment, and with each client. We embrace this focus on immediate, moment-by-moment, responsivity to client needs, meaning, intentions, and desired outcomes. We also broaden the lens of cultural responsivity to other relational practices that foreground client worldview, views of health and healing, and social locations in our conceptualization of client lived experiences and co-creation of client-centred counselling processes (Collins, 2018a).

We embrace cultural responsivity in this ebook as foundational to everything we do as counsellors. It is impossible for us to isolate from our cultural selves as practitioners. It is also important to recognize that every client we encounter brings their unique cultural selves into the counselling relationship and every other aspect of the counselling process.

2. Social Justice

Our approach to responsive relationships in this ebook is also firmly grounded in a social justice lens. Collins (2018f) defined social justice by the following broad aspiration goals:

(a) fair and equitable distribution of resources, information, services, opportunities, and privileges within society; (b) full inclusion and participation of all members of society; (c) enactment of legal systems and laws that guard against discrimination and protect human rights; (d) action aimed at ameliorating past and present social injustices, cultural oppressions, and inequities across persons and peoples. (p. 1016)

One of the risks of failing to acknowledge, and engage in critical reflection on, values is that counsellors may not recognize the role of sociocultural injustices, such as systemic racism, in client health and well-being. It is our position that the call for responsivity in counselling practice applies not only to clients’ cultural identities, but also to their social locations. In other words, each client’s position of power, privilege, and opportunity (or lack thereof) within society may have considerable impact on their health and well-being. Their social location also has the potential to limit their access to appropriate mental health services. Buying into the myth that all persons and peoples have the same access to resources and supports for health and healing serves to perpetuate these social injustices (Audet & Paré, 2018; Collins, 2018g; Collins & Arthur, 2018; Sue, 2015) and may result in counselling practices that are both nonresponsive and unjust. If you are not familiar with current perspectives on social justice in counselling and psychology, you may want to review some of the resources cited in this chapter, and to access some of our suggested resources from the previous section.

As we examine the process of conceptualizing client lived experiences throughout this ebook, the lens of social justice becomes important in positioning those lived experiences in context. Applying a systemic lens includes understanding the social determinants of health, which can place certain persons and peoples at an increased health risk (Fellner et al., 2016; Ginsberg & Sinacore, 2015; McNair, 2017; Reeves & Stewart, 2015; World Health Organization, 2019).  We assume a both/and approach to social justice that recognizes the importance of attending to the sociocultural contexts of clients’ lived experiences, while simultaneously engaging in justice-doing in the moment-by-moment conversations and relationships between counsellor and client (Collins, 2018d, Reynolds, 2010a; Reynolds & polanco, 2012). We will attend to, and challenge, the ways in which counselling processes themselves can reinforce or re-enact colonization and other forms of social injustice. We also will consider how social justice plays out in the values we counsellors communicate, the assumptions we make, the environments we create, the connections we build, the language we use, and the processes we engage in with clients. Collins (2018d) argued for a both/and approach that attends to what happens within as well as beyond the counselling encounter. Collins positioned social justice as a metatheoretical lens through which all aspects of the counselling process can be viewed. In this sense it becomes an ethical and metatheoretical lens (Audet, 2016; Collins 2018f; Dollarhide et al., 2016; Scheel et al., 2018; Winslade, 2018), rather than simply an outcome or destination.

Although the main focus of this ebook is on the interaction between counsellor and client(s), we believe it is important for counsellors to consider their roles in systems level change, both with and on behalf of their clients (Collins, 2018d; Ratts et al., 2015, 2016; Roysircar et al., 2018; Scheel et al., 2018). Collins (2018b) pointed to advocating for, and enacting, professional theory and practice change as one form of systems level intervention. We hope to prompt this type of systems change by re-imagining the nature of the client–counsellor relationship, foregrounding diverse perspectives on what it means to be in a healing-centred relationship, and challenging traditional language and norms related to counselling.

Throughout this ebook we will invite you into a process of applying and critiquing the metatheoretical lenses of cultural responsivity and social justice as we consider the processes of building and maintaining effective relationships with clients in service of understanding more fully their lived experiences. We begin from the assumption that all counselling is multicultural (Collins, 2018c; Paré, 2013; Paré & Sutherland, 2016; Ratts & Pedersen, 2014), in the sense that each client and each counsellor come to counselling as cultural beings embedded within multiple sociocultural contexts and systems. We will also continuously revisit the interplay of client and counsellor cultural identities (i.e., age, ability, gender, gender identity, sexual orientation, social class, religious or spirituality, Indigeneity, ethnicity) and social locations (i.e., relative positions of privilege or marginalization within society) (Collins, 2018; Ratts et al., 2015, 2016).

C. Responsive Relationships

Norcross and Wampold (2018) reported on the American Psychological Association (APA) Task Force on Evidence-Based Relationships and Responsiveness in a special issue of the Journal of Clinical Psychology. The main focus of the meta-analyses and systemic reviews included in the special issue was on how to enhance treatment efficacy by adapting or responding to the uniqueness of each individual client and the contexts of their lives. The importance of responsiveness in the therapeutic relationship was foregrounded: “The goal is for an empathic therapist to collaboratively create an optimal relationship with an active client on the basis of the client’s personality, culture, and preferences” (Norcross & Wampold, 2018, A Rose section, para. 3). The task force also looked at factors specific to particular client characteristics, which will be noted in other chapters of the ebook.

2. Relationship Factors and Client Factors

Based on the extensive research of the task force, Norcross and Wampold (2018) reinforced the messaging from the common factors research and other relationship focused models of counselling (e.g., person centred, feminist, relational cultural), and concluded that “the relational ambience of psychotherapy and responsiveness to patients prove typically more powerful than the particular therapeutic method or strategy” (The Third Interdivisional section, para. 3). One of the powerful messages in this research is that counsellors and counsellor educators should devote as much, if not more time, to relationship-building and client-specific factors as they do to particular theoretical principles and change strategies. For this reason, we have devoted ourselves entirely to foregrounding relational practices in this ebook.

We also hope to supplement the ideas presented by the task force by filling in some emergent gaps. Norcross and Wampold (2018) identified “(a) elements of the therapy relationship primarily provided by the psychotherapist and (b) methods of adapting psychotherapy to patient transdiagnostic characteristics” (Conclusions section, para. 8), adapted in Figure 2 below. What this research does not provide is a road map for how to develop the specific tools with which practitioners can build responsive relationships. It is here that we pick up in this ebook with a view to supporting counsellors to build incrementally a set of competencies for engaging in client-centred, collaborative relationships that enable co-construction of shared understanding of each client’s unique and contextualized lived experiences. These competencies include guidance about how to adapt therapist ways of being and relating to specific client characteristics (Norcross & Wampold, 2018).

Figure 2

Relationship Factors and Client Factors Influencing Counselling Outcomes

Note. The language in this figure has been adapted slighted as part of our philosophical positioning. We also eliminated factors specific to change processes, which are not addressed in this ebook. Adapted from “A New Therapy for Each Patient: Evidence-Based Relationships and Responsiveness,” by J. C. Norcross and B. E. Wampold, 2018,  Journal of Clinical Psychology, 74(11), 1889-1906, Conclusions. (https://doi.org/10.1002/jclp.22678). Copyright 2018 by John Wiley & Sons.

2. Evidence-Based Practice and Practice-Based Evidence

Through our review of the literature on common factors, values-based practice, and responsive relationships, we have provided an evidence-based practice foundation (i.e., application of knowledge emerging through psychological research) for centralizing relationships in counselling practice. However, it is important to recognize that much of the evidence we have examined also points toward the need for principles and practices for gathering practice-based evidence (i.e., direct and indirect feedback from clients) (Paré, 2013; Paré & Sutherland, 2016). Norcross and Wampold (2018) called on practitioners to engage in evidence-based relationships that are adapted or tailored to the individual client. This process of creating client-centred responsivity necessarily involves gathering feedback (practice-based evidence) from clients.  We appreciate the play on words suggested by Paré (2013), “This is about response-ability, the readiness and ability to respond” (p. 131).

D. Therapeutic Conversations

As noted above, our primary focus in this ebook is on the counsellor and client moment-by-moment process of relating and conversing. Growth-fostering relationships and therapeutic conversations do not simply occur because the counsellor is a nice person who wants to be helpful. What distinguishes these relationships and conversations from those clients might have with a family member or a good friend is the intentional use of particular relational and linguistic tools to support client health and well-being. There is no magic to these tools. It is the critical, intentional, and collaborative use of the relational and conversational tools that is helpful to clients.

1. Relational Competencies

A large body of literature has, over the past several decades, informed relational competencies in counselling  (Calvert et al., 2016; Gómez, 2020; Singh & Moss, 2016). We define relational competencies as interpersonal processes that influence the quality of the client–counsellor relationship and create space for growth to occur. What is important in this definition is that these occur at the level of the relationship and that they must be mutual. In Figure 2 for example, Norcross and Wampold (2018) identified empathy as a relational factor that has demonstrated efficacy in supporting counselling outcomes. However empathic I might feel toward a client, that empathy does not become a relational practice until it is expressed in a way that is meaningful and accessible to the client and in response to their specific needs in-the-moment.

Throughout the ebook, we will introduce a series of relational practices, connecting these to various points in the counselling process in which they may be particularly useful.

2. Just Conversations

The term just conversations has come to be associated with the assertion that social justice plays out in counselling in the moment-by-moment, utterance-by-utterance interaction between counsellor and client. What the counsellor says and how they say it becomes critical to ensuring the counselling process is responsive to the cultural experiences and contexts of clients’ lives (Audet & Paré, 2018; Collins, 2018d; Paré, 2013; Wulff & St. George, 2018). Audet and Paré (2018) asserted that, within the helping professions, certain discourses are privileged, which then influence how counsellors perceive clients and the stories that become available to clients to express their identities and lived experiences. Consider the following examples:

• Labelling a client, directly or in case notes, as dissociative, for example, sometimes happens without fully considering with them the meaning they associate with times they are not fully present. This practice puts a box around their experience that may be limiting or oppressive.
• Asking a client who presents as female what their husband does for a living may foreclose on client stories about their lived experiences as a queer person.
• Using the language of goal setting without collaborative conversation about worldview, might leave a client, who does not embrace the linear, eurocentric perspective on time, struggling to make meaning of the conversation.
• Engaging in “psychobabble” without checking to see what meaning clients make of the language to which counsellors are accustomed may be experienced as power-over positioning or simply inaccessible by clients.

We revisit the importance of justice in language throughout this ebook. We encourage critical reflection on the potential meanings associated with the use of particular language and advocate for tailoring language to each individual client to ensure both shared meaning-making. Examining words or phrases as meaning-laden metaphors for emotions, values, assumptions, beliefs, relationships, or experiences is a powerful tool for justice-doing (Paré, 2013) in counselling and for advancing the therapeutic process with all clients (Wagener, 2017).

As we worked together to develop this resource, we invested considerable time reflecting on language use in counselling practice, piecing it apart from its eurocentric roots. We invited colleagues to talk with us about the culturally embedded nature of counselling practices. Through these reflections and conversations, we made deliberate choices about how we describe the nature of counselling, relational practices, counselling processes, microskills and techniques. We will note our reflections and choices as they emerge in our writing.

3. Structures of Communication, Microskills, and Techniques

Both relational practices and just conversation are supported through the use of specific linguistic practices. Throughout this ebook, we move back and forth between attending to (a) the nature of the therapeutic relationship and the relational practices that support it and (b) the moment-by-moment conversations between counsellor and client, which involve particular linguistic practices. If you browse through most counselling skills or theory texts, you will notice that the term, skills, is used for a wide range of counsellor behaviours. This can make it challenging to talk about skills in a meaningful and transparent way. So, we have created a nomenclature that we hope will simplify things for you.

• Structures of communication form the first level of skill addressed in this ebook. You will recognize these as the basic linguistic patterns you use in your day-to-day communications. Such patterns take the form of (a) questions (i.e., how, what, where, when, why?), (b) statements, (c) minimal encouragers (ah, hmm), and (d) nonverbal behaviours.
• Counselling microskills are particular forms of questions or statements that serve a specific function within the counsellor–client dialogue. They are typically single sentences with a particular structure and purpose. For example, What is the most meaningful learning for you in this chapter? demonstrates the microskill of questioning.
• Counselling techniques are intentional linguistic practices that draw on one or more counselling microskills. These techniques often involve a short sequence of exchanges between counsellor and client for a particular purpose. For example, the counsellor might ask a question, provide some specific information, ask another question, and reflect back to the client what they understood from the conversational exchange.

The counselling microskills and techniques that are presented in this ebook are reflective of a collaborative and co-constructive relational stance (Collins, 2018; Paré, 2013), rather than a particular theoretical model. Their appropriateness with each client is determined moment-by-moment on the basis of client needs, preferences, cultural identities, and contexts, as well as the focus of the counselling process in-the-moment.

However, it would be misleading to suggest that there are no theoretical underpinnings associated with the concepts, principles, and practices we foreground in this ebook. We have drawn microskills and techniques from various counselling models, which we will make transparent as we introduce each one. However, as authors, we espouse a metatheoretical perspective that is positioned within the postmodern and constructivist paradigms. It will be important to attend to this metatheoretical lens as you move through this ebook, because it undergirds many of the concepts and practices we discuss and the ways in which we approach their use in counselling.

The intent of this chapter is to provide a conceptual overview of the principles that underpin the approach we have taken to centralizing relationships in this ebook. In Chapter 2, we begin to introduce specific microskills and techniques to support these relational goals.

COUNSELLING PROCESSES

In each chapter, we focus on particular elements of the counselling process, beginning here with welcoming clients. We deliberately use active verbs to emphasize the ongoing and iterative nature of many of these processes. By way of contrast, nouns such as initial intake are more static.

A. Welcoming Clients

The process of welcoming clients continues through the next few chapters as we talk about concepts such as hospitality and safety, for example. In this section, we focus initially on the welcoming processes that occur before you encounter clients for the first time (e.g., addressing stigma, engaging with social media), and then we focus on creating conversational practices that minimize language barriers.

1. Acknowledging the Stigma of Counselling

In 2021, both the academic and practitioner communities agree that stigma is a legitimate barrier for individuals attempting to access counselling and other mental health services.  Clients often report experiencing self-stigma, the internalization of negative stereotypes and beliefs (Stangl et al., 2019).  Although counselling has become a relatively common practice within health services in North America, it is important to recognize that many cultural groups around the world address mental health concerns through family, community, and cultural healers (Saleem & Martin, 2018). It may be a completely foreign concept to some clients to share their thoughts, feelings, and experiences with a counsellor or other healthcare practitioner. The result is a significant stigma associated with counselling services as well as pressure from family and community not to go to counselling (Qasqas, 2018; Saleem & Martin, 2018). This stigma may be strengthened by experiences of marginalization or discrimination when potential clients attempt to access services (Qasqas 2018; Nyland & Temple, 2018). For members of other nondominant communities (e.g., BIPOC, 2SLGBTQIA+, working-class), the stigma of mental health services may derive more directly from mistrust and fear based on negative, and sometimes traumatic, experiences within the healthcare system (Dupuis-Rossi, 2018; Lavell, 2018; Nyland & Temple, 2018). The result is that systemic barriers are erected to the accessibility and responsivity of counselling services, and counsellors must work to overcome these.

The continued stigma attached to mental health (World Health Organization, n.d.) is especially prominent in nondominant, racialized, and ethnic populations. Self-stigma and perceived stigma by others hinder racialized groups such as Black, Asian, and Latino individuals from seeking counselling (Cheng et al., 2013; Wu et al., 2017). In the text box below, Gina speaks specifically about her counselling experiences with Asian clients. Many more reached out to her during the pandemic, because they were experiencing anti-Asian racism, and because she speaks Cantonese, which provided a language and cultural bridge.

2. Communicating Responsivity

In this first chapter our focus is on welcoming clients into the counselling process. However this process of welcoming can begin long before the client and counsellor actually meet. It is important to consider the information that clients may access about you and your practice both online and in other ways that might influence whether they choose to make a connection with you in the first place. How are you communicating responsively to them as cultural beings, located in particular social contexts, with unique perspectives and needs?

Optimizing Social Media Presence

In the 21st century, there is little to no chance of escaping the internet and social media in our daily lives. Many counsellors share information and opinions on Facebook, Twitter, Instagram, and on other social media platforms. There is such an abundance of social media platforms that it is easy to lose track of our digital footprint. As a result, it is possible for our personal and professional lives to become blurred and intertwined. It is important to create personal–professional boundaries that enable therapists to hold a professional media presence, while privatizing other accounts by limiting access to only family and friends (Raypole, 2020).

Although regulatory bodies have yet to develop clear guidelines related to social media presence, there are ethical risks to therapists becoming  “friends” with clients on social media. Clients may post content in their own accounts that they do not intend for therapists to see, and they may not process this risk when they initiate or agree to connecting (Lannin & Scott, 2014; Raypole, 2020). Feng (2020) suggested that therapists not respond to clients who land on their Instagram or other social media pages; if Feng does respond, they  do not acknowledge their client–therapist relationship and treat the encounter similarly to bumping into a client in public. We strongly encourage you to think critically about this issue and to develop an explicit social media policy, one which you might discuss with clients as a foundation for being clear about professional boundaries (Lannin, & Scott, 2014; Raypole, 2020).

Counselling professionals must be careful about how they present themselves to the public, whether in an online or a face-to-face context. Remember, anyone can search the Internet and social media, making it crucial to be mindful of what you post. Many public figures have been criticized for posting or reposting opinions, jokes, or other comments on social networks. In some cases, this has resulted in public backlash and shunning. This is an example of cancel culture, a “the practice or tendency of engaging in mass canceling as a way of expressing disapproval and exerting social pressure” (Merriam-Webster, n.d.).

Providing Culturally Sensitive Space

Because of the stigma associated with counselling, direct experiences of discrimination and marginalization, and the lack of accessible and culturally responsive services, clients from marginalized communities may carry with them a sense of distrust and fear even once they make the choice to engage in counselling (Nyland & Temple, 2018). Once you have ensured that your Internet and social media presence communicates your values of inclusivity and responsivity to a diverse range of clients, it is important to turn your attention towards the physical space in which your services are provided.

Physical accessibility is an important starting place for ensuring enabling environments (Whitehead, 2015); this includes both accessible and gender-neutral washroom facilities. Collins (2018f) stressed the importance of attending to the messages communicated through choices of art and other decor, magazines and other print materials available in the waiting room, and other cultural symbols in your office environment that can include or exclude clients. An important survival strategy for some members of marginalized communities is vigilance about their physical environment, which may make them more immediately aware of subtle cues that suggest a potential lack of safety, invisibility, or marginalization. The process of cultural auditing (Collins et al., 2010; Collins, 2018e) involves focused and purposeful reflection on all aspects of professional practice. It is an important first step in welcoming clients into a culturally responsive and socially just counselling experience.

Preparing the Virtual Space: Teletherapy

At the time we were writing this, the world was, and perhaps still is, in the middle of the COVID-19 pandemic, and most graduate programs in Canada being delivered online using remote, synchronous or asynchronous learning. Concurrently, many counsellors and psychotherapists have transitioned their practice to teletherapy (Burgoyne & Cohn, 2020) to ensure social distancing and decrease further outbreaks, whether or not this is their preferred medium for working with clients (MacMullin et al., 2020). Some studies have found that digital mental health services can be just as effective as in-person therapy; they also offer convenience and the ability to reach people in more remote areas (Rutherford, 2020).

We will talk about Zoom fatigue (Fosslien & Duffy, 2020) in Chapter 11. However, please begin to apply some preventative self-care strategies that you have already developed as you engage in this virtual learning process. Create a routine to break up your times of intense focus as you would between clients. Take breaks for movement, meals, and self-care. Online learning and telehealth services are likely to continue to evolve into more commonplace experiences, in part because of the increased accessibility to services and resources they offer. It is important to adapt and to be open to diverse ways of offering counselling services to serve a wide range of clients. However, as healthcare professionals, you are expected to follow the guidelines available through the professional literature and regulatory bodies to ensure client confidentiality and safety.

3. Challenging Counselling Conventions

The term counselling conventions is used to describe the norms that have evolved within counselling practice in North America that determine the when (i.e., scheduling, length of session, frequency of contact, nature of endings), where (i.e., office setting, physical or virtual space), who (i.e., client, family members, support persons, interpreters), and what (i.e., activities, practices) that define, and sometime confine, engagement with clients. Many of these are embedded in eurocentric worldviews that themselves are embedded in classist, ableist, patriarchal systems (Collins, 2018c; Fellner et al., 2016; Lavell, 2019; Robertson et al., 2015). These may not fit well with the needs, cultural values, social locations, or contexts of clients’ lived experiences.

Adapting to Client Needs

One of the core principles foundational to this ebook is client-centred practice, which we reinforce through the conceptual framework provided in this chapter. Tailoring counselling to the specific needs, preferences, identities, contexts, and lived experiences of each client (Norcross & Wampold, 2018) necessarily involves critical reflection on counselling conventions. We invite you to consider how the when, where, who, and what of counselling might be adapted to optimize accessibility, responsiveness, and efficacy of counselling services. In Figure 3 we offer a few ideas about normative counselling conventions that may need to be up-ended or at least transformed responsively depending on the particular clients you work with and the contexts of their lived experiences.

Figure 3

Common Counselling Conventions

Standards for professional boundaries and norms have emerged to support ethically responsible practice, to which it is important to attend. However, these many of these standards evolved in colonial and eurowestern contexts without critical consideration of diversity. We encourage you to consider critically what it might be like to support responsive, client-centred norms, rather than inflexible, institutionalized norms. What does safe-enough space look like for you? How might the limitations of your comfort zone influence your responsivity to clients? What tensions might arise in challenging counselling conventions? How might you ethically and responsively manage those tensions?

Honouring First-Language

Language is intimately connected to culture. It is an important way in which cultural meanings are shared, and it can be difficult to communicate certain meanings without the original words or phrases in which they emerged (Boutakidis et al., 2011; Ko, 2014; Willis-O’Connor et al., 2016). Incorporating linguistic and cultural factors in counselling is culturally responsive when there is a mismatch of language between the client and counsellor (Kuo, 2018; Rodriguez-Keyes & Piepenbring, 2017; Seto & Forth, 2020). This includes inviting clients to use their first language, embracing language switching when clients feel more comfortable using their first language for self-expression, and using interpreters when needed (Kuo, 2018; Rodriguez-Keyes & Piepenbring, 2017; Seto & Forth, 2020). In the videos below, we invite colleagues who work with clients who face language barriers in accessing counselling services to speak to their experiences and to provide some guidance about how you might honour first language in your counselling practice.

In Canadian regions and systems in which English (or French) is the dominant language, systemic language bias often emerges. Both non-English counsellors and clients can run up against this form of cultural oppression. What might it look like to challenge the assumption that English should dominate counselling services in favour of acknowledging the limitations of monolingual environments in effectively servicing clients? Take a few moments to reflect critically on where the root of the problem really lies. As you prepare to welcome all clients into your counselling practice, what might you do to mitigate potential language biases you may hold?

REFLECTIVE PRACTICE

One of the main ways that counsellors and other healthcare practitioners continue to grow and enhance their professional competencies is through reflective practice (Scheel et al., 2018). Counsellor critical reflexivity involves attending in-the-moment, and in retrospect, to all aspects of interactions with clients, which requires increasing self-awareness of your thoughts, feelings, and behaviours (Collins, 2018c). Central to reflective practice is self-assessment and enhanced self-awareness of the ways in which your values, assumptions, beliefs, and other dimensions of cultural worldviews and social locations enter into the therapeutic relationship, either consciously or unconsciously (Collins, 2018c; Coulson & Homewood, 2016; Scheel et al., 2018). In addition to reflective activities interspersed throughout each chapter, we have devoted a section specifically to reflective practice to encourage active engagement in this core element of your learning process.

1. Preparing Yourself

In this chapter we have been focused on welcoming clients into your counselling practice; however, in this section on reflective practice, we shift our attention to how to prepare yourself to engage in responsive, culturally sensitive, therapeutic conversations with clients. It is important to consider how you bring yourself into these relationships, which may start with attending to your relationship with yourself. We are privileged to integrate, throughout this resource, a series of videos from Melissa Jay, who carries forward the important theme of self-care, beginning with the video below.

2. Enlisting Your Own Story

We invite you to begin your journey of self-reflection by identifying a challenge you are currently facing in your own life. You will be prompted to reflect on this challenge as you move through each chapter of the ebook. We hope that by enlisting your own story in service of your professional development, you will engage in another layer of self-reflection on your learning.

Choose an issue that is not easily resolved, but is also not deeply emotional or traumatic. Picture yourself preparing to seek out counselling for the challenge you have identified. Revisit the overview for this chapter in Figure 1, and reflect on the following questions. Take notes, create a mind map, make use of sticky tabs, or otherwise begin to organize your thoughts in some meaningful way.

• Visualize yourself taking preliminary steps to access counselling services. Where would you go? What first impressions would influence your choices? What red flags would you look for?
• Which of the common factors resonate for you? Which of these have supported your growth or healing in other relationships or previous counselling experiences?
• What values would you look for in a counsellor? Why are these values important to you? How do these desired values relate to your lived experience as a cultural being, located within specific family, work or school, community, organizational, or broader sociocultural contexts?
• What type of client–counsellor relationship would feel responsive to your preferences, identities, and social locations? What evidence might you look for to ensure your needs would be met?
• How open are you to discussing your challenges with a counsellor? What might hesitancy, fear, or shame tell you about your assumptions and beliefs about the practice of counselling or helping professionals? Where are those barriers rooted for you?
• How important would it be to work with a counsellor who shared your first language? If you are a multilingual person, what would enhance your ability to express yourself freely and to ensure shared understanding?

Take a few moments now to begin to create your story, then:

1. Note what is most significant and meaningful to you.
2. Draw on images, memories, pieces of literature, or photographs to capture your lived experience.
3. Think about how you might begin to share your story with another human being.

3. Engaging with Macey’s Story

Next we offer you the beginnings of the story of Macey that will carry forward into subsequent chapters. This story was created from composites of various clients we have encountered throughout our careers as well as our own lived experiences, both personal and professional. The purpose of following the story across chapters is to give you another way to engage in reflective practice. Please position yourself in the role of counsellor. We encourage you to use the story as a springboard for your own ongoing reflection and competency development. If you are using this ebook as part of a course, your instructor may choose to use this story as a starting place for class conversations.

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