Counseling research and practice maintains a professional obligation for cultural competence when engaging all clients in a counseling relationship, and a need for creativity when engaging diverse populations around the world (American Counseling Association [ACA], 2014, Ratts et al., 2016). The effort to develop culturally competent counselors remains a priority within the profession, and counselors in training are encouraged to enhance characteristics of flexibility, creativity, tenacity, vision, cultural humility, a desire to learn, and a willingness to eschew traditional ethnocentric views of counseling as often demonstrated in Western counseling strategies (Ægisdóttir & Gerstein, 2005; Consoli et al., 2006; Forrest, 2010; Heppner, 2006; Leung, 2003; Tang et al., 2012). Scholars have identified the lack of international standards for counseling to be an ongoing challenge for the profession (Forrest, 2010; Schofield, 2013; Stoll, 2005; Szilagyi & Paredes, 2010), along with the need for more adequate training and evaluation of counselor competency globally (Forrest, 2010; Jimerson et al., 2008).

The COVID-19 pandemic impelled a keen awareness of the interconnectivity between global cultures. While the difficulties of this physical virus expanded globally, the decline of mental health also became pronounced in the wake of this worldwide medical crisis, with as much as a 30% increase in symptoms of anxiety and depression (Panchal et al., 2022). The World Health Organization (WHO, 2022) reported about the pandemic, “Depression is one of the leading causes of disability. Suicide is the fourth leading cause of death among 15-29-year-olds” (para 1). The WHO went further to emphasize the urgency of addressing mental health to avoid inhibiting necessary global supports. People with mental health issues die earlier and experience more human rights violations, and mental health services are not available in many where they are desperately needed (WHO, 2022). To reinforce applications of mental health support from other countries, ongoing research may help inform practice in settings that have not encountered what professional counseling has to offer.

For the purposes of this study, counseling values are defined as the common principles, standards, and policies that guide ethical practices and assumptions within the counseling profession. While counseling professionals are defined differently in various cultural contexts, a working definition is articulated later in the recruitment criteria for the study and may generally be understood as professionals recognized in various countries to offer counseling services. Such counseling professionals may be represented under different professional identities or labels depending on the cultural context. These frequently appear as codes of ethics, such as promoted by the American Counseling Association (ACA, 2014), the British Association for Counselling and Psychotherapy (BACP, 2018), and Persatuan Kaunseling Malaysia (PERKAMA) (Ishak et al., 2012), and the Australian Counselling Association AUCA, (2022). Further exploration within the literature provides greater definition to how counseling values may appear across cultures.

International Counseling Values in the Literature

This review of the literature considered professional multicultural counseling practices to establish a foundation for exploring the common values among counseling professionals throughout the world. Scholarly and authoritative content on international counseling continues to expand, with cultural competence remaining an important focus of attention for ethical practice around world (ACA, 2014; AMHCA, 2020; BACP, 2018; Ishak et al., 2012). Within this standard, the application of cultural competence in counseling is often focused on supporting clients domestically who have international backgrounds. Professional researchers in the literature identified these applications as highly valuable, yet they retained a limited scope when considering how to apply principles across other cultural contexts based on the findings of this study.

Contextual Awareness

Hook and Vera (2020) described current global themes in mental health through a study researching leaders in international counseling psychology, which included attention to holistic health, cultural relevance, partnerships, collaboration, and sustainability. They observed that counseling professionals offered greater benefit when responding to expressed community needs rather than the needs outside professionals may assume. They highlighted how their findings suggested research and design methods also must be relevant to local contexts counselors may be investigating (Hook & Vera, 2020).

Reinforcing this point, Koç and Kafa (2019) explained how three forms of psychotherapy appeared evident across cultures: (1) imported Western-origin psychotherapy and some spontaneous alterations to observe culture, (2) systematic adaptation of psychotherapy methods according to needs of people in a specific culture, and (3) models that are products of the cultures themselves. They further described how the practice of psychotherapy based on needs in the culture has limited research that takes culture into account. These examples suggested counselors will benefit when applying contextual awareness and different counseling approaches internationally (Hook & Vera, 2020; Koç & Kafa, 2019).

Adaptive Concepts

Counseling concepts that hold value across cultural expressions may appear differently than expected. Chen and Hsiung (2021) found that many student therapists in Taiwan were challenged to articulate and operationalize the essence of the self (i.e. self-concept, self-identity, self-actualization), which is a concept that predominates many Western therapy models and classroom settings. They recommended preserving the general concepts but adapting them with terms like “self in relation to others” and “self in context,” which were more culturally familiar.

Several contextual factors influenced the Chinese counseling students’ engagement in self-reflection with a study conducted in Taiwan, including conforming to collectivist values, valuing academic success and filial piety, saving face in relationships, and observing myths about the helping professions (Chen & Hsiung, 2021). With awareness of how these tendencies influenced these Chinese counseling students, Chen and Hsjung (2021) discovered that a course on counselor self-awareness and self-care improved Chinese counseling students’ engagement with these concepts. In a similar way, Matthews et al. (2018) described a study where higher racial identity positively correlated with multiculturally competent skills. A strong culturally-appropriate self-awareness offered clear benefit.

Other ways to adapt to different cultural settings included the development of the therapeutic alliance in the counseling relationship. Lee et al. (2019) described how counselors need to prioritize culturally sensitive practices in the therapeutic alliance for cross-cultural dyads, which may include negotiating language and various understandings. Cross-cultural training may help counselors adapt to various cultural settings, yielding adaptive traits such as cultural humility, necessary self-analysis, collaborators with service recipients, perseverance, communication skills, and supervision (Hook & Vera, 2020).

Other ways that demonstrated how professionals may develop adaptive concepts for counseling included, but were not limited to, increasing cultural awareness (Hays et al., 2010), increasing awareness of varying cultural attitudes toward the counseling profession (Al-Krenawi et al., 2009; Young et al., 2003), emphasizing the importance of therapeutic presence or attunement (Srichannil & Prior, 2014), and cultivating emotional intelligence in counselor education (Miville et al., 2006; Leung, 2003) further promoted counselor development with increased opportunities for international travel experiences, increased funding for programs with an international or cross-cultural focus, and a shift in admission criteria to place greater focus on internationalism, including bilingualism, living abroad, international travel, and other life experiences.

Diversity Within Groups

Counselors demonstrated an easier time offering counseling skills across multiple cultures or identities when they develop an awareness of cultural best practices. Koç and Kafa (2019) highlighted how incorporating indigenous practices can be difficult in any counseling setting, especially because there may be a lack of incorporation of counseling methods between various subcultures or ethnic groups even within the same country (i.e. between Aboriginal and non-aboriginal populations). Many countries have called for greater synergy between modern and traditional methods as a result, so that there is not just one focus to the exclusion of the others (Koç & Kafa, 2019).

One example of this multiple focus for diverse groups included the “Clubhouse model” described by Agner et al. (2020), which promoted the use of day programs that fostered social support and activity for people living with severe mental illness. Such programs occurred in Hawaii, and Agner et al. (2020) described the diverse themes important to wellness involving connection to place, connection to community, connection to better self, and connection to past and future. These connections to wellness from this study reflected consistent themes with indigenous cultural values.

Multiple studies addressed ways for counselors to thoughtfully approach cross-cultural populations, and researchers described important concepts, like emotional intelligence, to communicate safety and reinforce the therapeutic alliance despite cultural differences (Duff & Bedi, 2010; Milville et al., 2006; Srichannil & Prior, 2014; Young et al., 2003). Duff and Bedi (2010) emphasized the importance of the relationship with engaging diverse groups, and carrying a posture of attention to detail, honesty, and physical calmness as significant ways for the counselor to communicate care to their client in cross-cultural settings. Researchers also noted that participants identified personal qualities as the paramount tool of the counseling process, even over technical skills or theoretical orientation (Bojuwoye, 2001; Srichannil & Prior, 2014).

The purpose of the following study is to explore the common values of counseling that exist among counseling professionals in a variety of international cultural contexts. The study employed a phenomenological approach to understand how the unique experiences of these counseling professionals can inform awareness, practice, and training for multicultural and international counseling practice.

Methodology

This qualitative study reflects a phenomenological theoretical approach to explore the experiences of 16 different counseling professionals serving in a variety of international settings. Researchers applied concepts of Interpretative Phenomenological Analysis (IPA) more specifically, because the approach helps guide the exploration of both participant thoughts and experiences (Cook et la., 2016; Smith & Osborn, 2004). As Palmer et al. (2010) described, “the aim of IPA is to understand and make sense of another person’s sense-making activities, with regard to a given phenomenon, in a given context” (p. 99). Though neglecting the social context to focus too heavily on individual experiences has been a criticized risk of IPA (Smith, 2011), the researchers worked to reduce this risk by focusing the research questions directly to the unique cultural experiences and perspectives of the participants. The Qualitative method offers benefit to this effort as Gergen et al. (2015) described, “Added to the goal of prediction are investments in increasing cultural understanding, challenging cultural conventions, and directly fostering social change” (p. 1).

A phenomenological theoretical framework allowed the research team to gain further understanding of the unique experiences and perspectives of each participant and their setting, while observing common themes that emerged within the data. The most common method of acquiring qualitative data through IPA is through thorough interviews (Smith, 2011), which were conducted through private and secure online video software while participants remained in the comfort of their natural settings throughout the recruitment and interview process. IPA studies were found throughout the health psychology and mental health literature (Smith, 2011), with similar models used to identify cultural needs within mental health training programs (Thomas & Brossoie, 2019), understand international counseling doctoral student preparation (Li & Liu, 2020), and explore social justice and multicultural competency in counseling school developmental models (Cook et al., 2016).

The primary research question for this study examined, “How do counseling professionals connected through international counseling associations experience counseling professional values within different cultural contexts?” From this primary focus, participants were asked the following sub-questions:

  1. 1.

    How do counseling values relate with the participant’s culture?

  2. 2.

    What needs of the participant’s culture would benefit from greater attention from the counseling profession?

  3. 3.

    How can the counseling profession best meet those needs?

  4. 4.

    What are key ways the participant’s culture can enhance or inform counseling values?

  5. 5.

    What are natural venues from which counseling practice is accepted and valued most readily in the participant’s culture?

  6. 6.

    What else can the participant share about experiences with integrating counseling values in the participant’s culture?

Researcher Roles

The research team included investigators from the Counseling Department of The Family Institute at Northwestern University. The primary researcher also served as a core faculty member and research sponsor, who organized the team of graduate counseling students to process and evaluate the data for the study. All researchers received proper social research ethics training through the required sources at Northwestern University to ensure compliance with confidentiality and privacy standards, and the study was approved by the Internal Review Board (IRB) at Northwestern University (#STU00207061).

Each researcher provided equal insight and reflection on the development of this study. These contributions included researching the literature, transcribing and analyzing data, and identifying themes for further discussion and application from the counseling professional participants of the study. Because of the nature of the project and the inclusion of participants connected through international counseling associations, some of the participants of the study had previous interactions with the primary researcher through professional association interactions. The second and third authors contributed to the study through researching the literature, providing input to the writing, and offering consultation throughout the data analysis process described.

Procedures

The primary researcher conducted 60-minute interviews with 16 counseling professionals around the world. Recommended sample sizes for a qualitative study with a phenomenological framework can range from as few as six participants (Schreiber & Asner-Self, 2011) to as many as 10–15 participants (Johnson & Christensen, 2012; Smith, 2011) emphasized how the intensity of the analysis process with IPA results in the sufficiency of smaller samples sizes. A total of 16 participants were chosen for this study in observation of the eight regions identified by IAC, which employs a model of representation on the Executive Council (EC) by preserving a voice of leadership for representatives from Africa, Asia, the Caribbean, Europe, Latin America, the Middle East, North America, and Oceania (IAC, 2022b). Two participants from each region provided a purposive sampling method with at least two perspectives for each region. The selected participants for this study originated from the countries where they currently lived and worked in professional counseling, and participants from two different countries from each region were selected to enhance the voice of those areas.

The goal of this study was to have a diverse population of counseling professionals that could speak knowledgably about counseling values in relation to the profession globally. To ensure equal representation of participants throughout the eight regions of IAC, researchers used a strategy of purposeful snowball sampling to acquire willing participants who could inform the study (Bogdan & Biklen, 2007). Researchers asked each participant for referrals to additional counseling professionals that could be willing to participate in this study.

The interviews were conducted through private and secure online video software, and participants remained in the comfort of their natural settings throughout the recruitment and interview process. The interviews lasted 60 min, were recorded with participant consent, and explored the specified research question and sub-questions identified. All associated data were stored on a private and secure data platform only accessible to the research team, who transcribed each interview, reviewed the content, and analyzed the data. All the interviews were conducted in English. With two participants another counseling professional proficient in both English and the language spoken by the participant assisted in conducting the interview. The interpreters also assisted these participants with completing the study’s consent form and demographics form.

Participant Criteria

Because the definitions of counseling vary across cultures and countries, the study focused on the definition of what constitutes a professional counselor within a country they live and practice, and as observed in their local culture. The National Board for Certified Counselors-International (NBCC-I, 2012) described this approach to determine eligibility of credentialing candidates internationally based on five universal criteria. (1) formalized counselor education, (2) supervised counselor experience, (3) assessment-based credentialing, (4) standards of professional practice and conduct, and (5) continuing education requirements. Individuals excluded from the study sample included anyone who did not meet the criteria for all five of these categories defined by the NBCC-I, which may be specified and interpreted differently between each country.

Most of the interviews proceeded with participants who have a working knowledge of English, but two interviews proceeded through the use of an interpreter. In these two cases, another counseling professional proficient in both English and the language spoken by the participant assisted in conducting the interview. The interpreters also assisted participants with completing the study’s consent form and demographics form.

The demographics form explored details of the participants, verifying the NBCC-I (2012) criteria as defined in the context of their countries. The specific details of each participant are not disclosed to ensure confidentiality, but the demographics offer greater detail to the professional pool of participants. Each participant reported descriptions that provide context for the following: highest degree, current title or position, licenses, certifications, or credentials in counseling or related field, years of experience in professional counseling, country of origin, country of current professional service and practice, counseling domains included with professional experience, primary counseling domain, and identified gender (See Table I). Participants were guaranteed their privacy would remain secure for the study, but that only general findings would be shared in relation to their data.

Recruitment

To preserve the diversification of voices from the counseling professionals equally, stratified purposeful sampling was initiated when the primary researcher sent an e-mail to the EC members for IAC (2022b). The EC members were asked to consider participation and recommend any other professional counselors they believed fit the criteria of the study from their region. The email addresses to the EC members throughout the world were obtained through IAC interactions. Once identified through this method, potential participants received a direct e-mail invitation with a description of the study. Those who responded and agreed to participate received a follow-up e-mail to setup the time for the interview.

When an agreed time was established, a final electronic calendar invitation was sent confirming the time to participate in the interview, along with the links for their consent, their demographic information, and the video meeting link for the interview. The consent form included details about the study, how their information would be used, the risks and benefits of participation (no financial compensation was included), contact information to reach the primary researcher or the university IRB department, and verification that they may withdraw their information at any time. Once the interviews were completed, the researchers sent a follow-up email to thank the participants for the interview and verify their ability to contact the research team at any time. This five-stage process of reflected the following steps:

  1. 1.

    Request referrals from the IAC EC.

  2. 2.

    Send direct participation requests to potential participants.

  3. 3.

    Send invitation to schedule the interview.

  4. 4.

    Send calendar invitation email to conduct the interview (with links to complete consent forms and demographic forms electronically).

  5. 5.

    Send follow-up email expressing thanks and offering contact information.

Data Analysis

The researchers collected, reviewed, and analyzed the interview data through a process of coding for each transcript of each interview. Interpretation of the data included an inductive method using both first and second levels of analysis to highlight common experiences of the participants interviewed (Bogdan & Biklen, 2007). Phenomenological approaches used to code the data in this study include descriptive coding (first level), open coding (second level), and theming (third level) (Flynn & Korcuska, 2018). The first level involved coding the content of the interview based on basic descriptions of the responses throughout each transcript. The second level involved the researchers going back over the data to code categories that had emerged from the data. These coded concepts were compared across all interviews to identify core themes. The third level resulted in condensing and grouping the categories that emerged into themes that may be reported and discussed further.

At each step in the process, each researcher reviewed each transcript independently and in great detail before coming together to compare findings in a collective researcher discussion. Each of the three levels of analysis of the data were infused with mutual consultation in researcher discussions to distill the essence of the resulting themes as reflected in Figure I. The demographic data completed for each interview provided additional layers of detail that helped describe the participants of the study and verify their qualifications for discussing the field.

Fig. 1
figure a

Three Levels of Data Analysis

Full size image

Reliability, Validity, Generalizability, and Trustworthiness

The researchers employed a peer review system of reviewing the data to ensure accurate and reliable interpretation of the transcripts and content (see Figure I). The researchers engaged in the first stage of coding independently, with content categorized inductively for each transcript. After the initial level of coding was completed, the research team deliberated on the content to compare similarities and differences. The vast majority of the first-level coding was consistent across the research team, but with some minor adjustments. At the second level of coding, the research team independently identified themes that emerged from the data. The team met and compared the themes, only to find significant consistency again. The researchers discussed some of the minor differences and agreed upon common language that captured the essence of the data into clear themes. This process allowed for multiple levels of blind review and comparison to enhance reliability of the data.

The same research questions and sub-questions were used for each of the participant interviews to ensure continuity and validate the commonality of responses. The research questions were discussed by the research team and formulated to ensure they expressed important values of the counseling profession, multicultural best practices in the field, and the phenomena being explored in the study.

While the interview responses were diversified across many cultures, countries, and ethnicities, the data also must be interpreted with some caution regarding generalizability. Two representatives were interviewed from each global region, which offered some level of variety in understanding diverse perspectives on counseling values. However, there are many other counseling professionals that have the potential to answer any of the questions differently. Because of the global focus of the study, a higher number of participants was utilized to enhance proper representation (Johnson & Christensen, 2012; Schreiber & Asner-Self, 2011). Although participant criteria defined counseling professionals in their context, the participants in each region only represent two opinions out of possibly many others. Still, the commonalities across cultures offer a helpful starting point for understanding how the phenomenon of counseling values are understood worldwide. While recognizing this caution, researchers have emphasized that qualitative phenomenological studies do present opportunities for some general applications, particularly with eidetic generalizability with a focus on the phenomenon and not a number assumed to create saturation (Englander, 2019; van Wijngaarden et al., 2017).

To reinforce stronger trustworthiness regarding the phenomenon of international counseling values explored in the study, the research team employed several techniques, including memoing, researcher positionality, and participant checking (Bogdan & Biklen, 2007). Memos were taken with each interview to provide context when reviewing transcripts throughout the data analysis process. Figure I reflects the researcher discussions where efforts to recognize researcher positionality as both outsiders with participants culturally but semi-insiders professionally remained an important part of the data analysis (De Cruz & Jones, 2004; Gair, 2011). The researchers also provided each participant with all their referenced material and the context of interpretation so they could verify the accuracy of the data interpretation through member checking. This approach seemed especially important because English was a second language for the majority of the participants, although they largely demonstrated language fluency. The only exception was with the two participants who required translation, and the interpreters used for those interviews were included on the email with the participants to view the interview content and offer feedback. There were no concerns raised by the participants regarding the content and the application of their words to the findings in the study, so the member checking provides greater confidence that the data shows a trustworthy representation of the interviews.

Results

The volume of data provided rich and relevant insights from the professional counseling participants. The overarching themes identified by the research team included: (1) Recognizing valued approaches, (2) Adapting to community settings, (3) Understanding common professional issues, and (4) Maximizing cross-cultural practices. Because the content touched on so many important areas, and the researchers decided to include the voices of the participants as much as possible. This article will focus on the content for 1) Recognizing valued approaches, with future articles sharing data from the remaining three sections that follow, including sub-themes for each category. The following demographic information offers a description of the participants that provided the content for the phenomena explored in the study.

Demographic Details

Demographic information provides greater definition to the credentials, experiences, and identities of the participants, without compromising privacy outlined in the participation agreement. Table I offers a list of features that contextualize participant contributions in the data.

Table I Participant Demographic Details
Full size table

Recognizing Valued Approaches

Participants consistently described several prominent approaches to counseling that occur or are needed within their context. The areas of commonality described in this article became apparent in the data with a variety of sub-themes. These notable themes included marital and family counseling, child and school counseling, faith integration, indigenous practices, and person-centered safe spaces. Table II offers data on what discussions were addressed by which country participant. To preserve anonymity, each participant is identified by the name of the country they represent. Table II details the eight regions of IAC, along with each country participant. The topical areas they addressed are also included in the table.

Table II Recognizing Valued Approaches Sub-themes
Full size table

Marital and Family Counseling

The importance of providing marital and family counseling was vocalized among 69% (n = 11) of the 16 participants. The role of family and the importance of the marital relationship are recognized as high priorities, emphasizing in a variety of ways that counseling professionals must be ready to provide marital and family counseling in many contexts. Samoa highlights, “Most definitely. The family systems here would definitely benefit from more counseling in terms of how family systems operate within the changing world.” Russia also concurs with the importance of family work when saying, “I know that family therapy [and] spouse therapy is very widespread here at this time.” Counselors come with skills that can address the conflicts that emerge among families, and Canada describes some of the ways professional counseling is needed for families in the country by sharing how counselors are “targeting all levels of the family and often running some parenting programs and some couples programs. . and some family counseling.”

Preserving marital relationships was viewed as central to family support among counseling professionals. Zimbabwe reports some of the greatest needs exist “between spouses, between partners who could be cohabitating. . . It is also true with the starting a relationship or starting a marriage.” Afghanistan also describes how more people are encouraged to seek out pre-marital counseling or divorce counseling in the country. They highlight a need to focus on prevention rather than intervention, and reported others “. . would refer the families that need premarital or divorce counseling and this stuff. If this is expanding in the country, there would be a lot of cases now [in the] family area and for family counseling.” Afghanistan goes on to explain, “this can prevent a lot of the divorce and. . prevent it [from] having a lot of children of families that were divorced.”

Iran also emphasizes the importance of marital support and described how this form of counseling is much more accepted in the culture. Both Iran and Afghanistan emphasize that the acceptability of counseling for couples and families is high among many of those who are highly educated. Iran describes “Recently, it’s much, much better. In premarital counseling for example, a lot of people would go, a lot of new people, and the new bride and groom to be. Before that they would go and see a premarital counselor.” The popularity of counseling among married couples offers hope that ongoing support for the family and individuals may occur. Argentina also describes some of the positive ways that counseling can shift the perspectives of people in relationship by offering a metaphorical monologue: “Well, I have a day with my partner. We are angry. I don’t talk to anybody and I can see the difference where I stay in this way.” Argentina goes on to describe how this relationship can affect other relationships but coming to counseling to talk with someone “is a huge support.”

The commitment to continue supporting family units remains a common cultural emphasis among the participants represented. When describing how important family is within the culture overall, Jamaica explains:

The family unit is critical, so, while it may look fragile and sometimes fractious, as my grandmother would say: Family is family. You know, that’s part of it. We have an old proverb that says: ‘[Your] finger stinks? You don’t cut it off.’ In other words, not because you have a rotten apple in the family, you disown them. You still try until it’s absolutely impossible to do anymore; then you may have to cut the finger off, but that’s not your first course of action. And that includes people overseas, family overseas supporting family here. And I think that happens for many migratory populations, not just Jamaicans.

Others elaborated on the challenges of lacking resources and economic hardship and their negative impact on the family. Samoa explains that ensuring support for families who are struggling is a primary focus of counseling: “The spiritual leaders, the ministers and pastors, they’ve worked quite [hard] to support families.” The problems have become evident, as Samoa describes, “In terms of family systems, [this] will be really for counseling to really take off, because now we’re starting to see a lot of domestic violence here.” Malaysia describes similar concerns evident within the culture as a result of the need for family counseling:

To be honest with you, family is one of the systems that we really need to work with, and due to that, there are a lot of connected issues, such as the drugs and substance abuse, domestic violence, of course mental health counts as one of the issues. And for your information, throughout my state, if I’m not mistaken, we are the highest. We have the highest rate of divorce and then a lot of broken family involved, and a lot of, what do you call that, orphans, as well.

Family counseling interventions may differ according to the context. Participants describe specific approaches for how to consider family involvement in the professional counseling process. This is evident for India, who offers detailed perspectives on how to support families in their culture: “We started out with the Western model of foster family care, you know, selecting strangers to care for the children and then counsel there, you know, the foster parents and the children.” This soon proved to be a poor fit for the culture in India, so they adjusted their approach and, “We realized that those models are not working completely and so we decided. . we had to take on a more familial and community-oriented perspective.” Adapting the model of counseling and “kinship care” to support the needs of children and the foster families that take them increased the success of their efforts. India reports this new model of support was adopted because “what works well in our culture is family-centered counseling and community-centered counseling,. . you can’t keep families and communities out from the context of that individual.” Both India and Samoa explain how even concepts of confidentiality are handled more openly when working with families in counseling within their cultures. As India describes, “Confidentiality, yes, it definitely has a place, but we understand it a little differently, because we have areas where we need to share it.”

In a similar way, Wales discusses ways of seeing counseling integrated into the culture through a focus on learning how to value listening, not only in families but also in the communities in which they live: “So, I think you’ve got these informal networks of value within communities, and some of that is within families, but some of it is wider than that.” In this way, Wales describes the way counselors can offer greater benefit to the people they serve.

Child and School Counseling

Counseling is frequently identified as highly valuable for children, particularly within school settings. The attention of child and school counseling occurs among 50% (n = 8) of the participant responses. Wales describes with pride, “Here in Wales, for example, we were one of the first places in the UK [United Kingdom] to have a counselor attached to every primary school.” This approach leads the way for the rest of the UK to follow the example of Wales so that “counselors can advise schools and their schools’ management on aspects of the way they do things which might actually be contributing to the problem.” Malaysia also reports, “Most of the schools in Malaysia, they do have school counselors,” which is identified as a primary venue from which counseling services are offered.

Samoa describes a heightened interest in counseling children, providing an example of a recent training program offering courses in child counseling, where they “just finished one of child abuse, and now it’s child counseling skills, and the interest for to take on these courses are quite difficult to get in.” This reality convinces Samoa that “a lot of more people are taking counseling seriously in Samoa.” Counseling also receives more favorable recognition from the community in Iran. When discussing the values of counseling that exist within the community, Iran shares:

The other thing is any kind of counseling for children. So, children, you know parents, doing anything for children. So, before they wouldn’t go to see a counselor for, you know, for a children’s problem, but at the moment counselors who are working in the area of children, any kind of issue like behavior, school counseling and these things, these are the ones that have a lot of clients.

Canada describes the system of support children receive among Canadian mental health professions: “Children and adolescents do have access to school counseling and they would access through that way.” This approach provides an entry point for many young people, as they can receive further services if needed by receiving a referral to the local health services department. Anything beyond, “how you fit or don’t fit within the school system and problems you’re having there,” would result in having a referral to public health services for more in depth counseling support. When describing how professional counseling can best support needs of the culture, Jamaica expresses,

I think our school counselors have a role to play here, but they are overwhelmed. There are few in a school and what they’re being asked to do is just too much. You’re going through the motions, but are you having an impact? Yes, you may be impacting a few students, but how can you use your position in a role of advocacy as opposed to being just a part of the system?

Other countries, such as Jamaica, reflect a broader concern about how counseling is applied to young people, often centering on behavioral issues. Zimbabwe describes how counseling has often focused on behavioral issues with “teachers in schools and also in communities. . these are the contexts we do this. It’s about the discipline, trying to ensure that, you know, pupils to students behave in school settings.” Similarly, Trinidad explains, “Trinidad and Tobago are in a time where young people are not valued, especially young people who come from poverty-stricken environment, young people who are really struggling.” Trinidad explains how students who need services most are not receiving the services they badly need: “Our education system only focuses on, let’s say the 20% who are able to maneuver their way into the kind of education system that we have; it’s very academic-oriented.” Trinidad calls for increased reform in how the country looks at supporting young people in schools and elsewhere with greater mental health support:

I say that if we look at young people as potential criminals, we will do that [have armed guards around schools]. But if we look at them as potentially productive citizens of this country, we will put more guidance officers, more psychologists, more social workers. . .. We need to really look at our young people as productive citizens, potentially productive citizens, and provide the environment, provide professionals, that will be able to help them.

Faith Integration

Among the valued approaches identified by participants, the importance of faith integration became apparent across a variety of cultural, faith, and religious backgrounds. More than a third of participants (38%, n = 6) report the significance of faith-based counseling services, describing its integral nature in the culture. Canada reports, “there’s a lot of local counseling and some of them are more Christian-based while others are more open to whoever.” Jamaica likewise reports, “A key place is church-based counseling.” The importance of faith, religious, and spiritual integration in counseling support is regarded highly among the participants who addressed the phenomenon.

Samoa describes the value of spiritual needs and the expectations of the people in the culture: “Yeah, I mean the spiritual side of it’s always going to be there, because in each village is at least one, two, three different denominations of the spiritual leaders—the pastors and ministers.” The churches in Samoa are working to increase mental health awareness among their pastors and leaders of churches. Samoa works as a counselor with the church, but also in a pastoral role. Zimbabwe also describes their own dual roles in both counseling and church ministry: “I am a registered licensed practitioner for counseling, and I am a minister of religion. . . I both assist practicing ministry clergy and also the congregants themselves.” The integration of faith is clear with the experiences of both Samoa and Zimbabwe, and in the multiple professional roles they serve in their communities.

Participants also report that counseling frequently occurs within religious or spiritual locations. Malaysia describes ways counseling becomes integrated with religious beliefs through the religious settings: “My country is Islamic country, so. . I would say if people can use the mosques. . the churches. . this kind of, what do you call that, medium. . . it should be like that.” Malaysia provides reflections on targeting the faith experience of the client, yet they warn, “We need to be very careful as well, when it comes to this churches and mosques and temples. Yeah, because definitely we really need to understand the spiritual, what is it, the religious matters.”

Even if people do not have a religious affiliation, Jamaica explains how “They will make use of the church-based counseling, because there is an inherent trust in religious leaders and of religious leaders.” Integration goes even further with counseling in the church in Jamaica: “Some churches have professional counselors. They offer a space where a professional counselor can operate from at a very discounted rate.” Because of the significant reliance on the church in Jamaica, they share further initiatives to encourage clergy in their efforts to provide mental health support: “And then, of course, there is the pastoral counseling, pastoral work done by pastors. One of the things we have tried to do is to help pastors understand where their limitations are so they don’t cross over into [other] areas.”

While many of the participants share the openness of religious or spiritual institutions offering counseling, Trinidad describe ways in which some faith settings may be restricted to only those ascribing to that particular faith, which can pose some challenges:

There are some spaces that, you know, are Muslim, and they will not accept other faiths. And there are some spaces that are Hindu and they will not accept [others]. Some schools will not. It’s just for Hindu children, [or] it’s just for Muslim children. And if you are not of the faith but you get into the school, you have to follow their faith. . .. You have to do things the way they do it. .. which. .. causes a lot of confusion in the young people.

Indigenous Practices

Participants demonstrate that counselors can recognize the importance of indigenous and traditional practices regularly by observing the values represented within the culture. Indigenous practices were described by 38% (n = 6) of the participants in detail. Australia depicts multiple levels and values integrated into the helping roles of the those with indigenous heritage, and how traditional practices have begun emerging as central counseling values in the country. According to Australia, “. . healing practices, particularly from Aboriginal and Torres strait islander peoples are being brought into mainstream counseling. For example, in my professional association, we have like a college of indigenous healing practitioners and those long held historical values.” Australia goes on to describe some of these practices, including dance therapy, storytelling, and going outside on “bush walks.”

Canada underscores some of the ongoing activities related to integrating indigenous practices in counseling: “I’m helping with. . the development of competency and have been on two committees for that. . . I’ve written, and am now working on, indigenous competencies.” Canada offers further illustration of the kinds of inclusivity and welcoming behaviors promoted in their culture:

.. . in my culture there’s something called the ‘wampum belt.’ It’s a belt that shows inclusivity, that we’re two different people but we are walking together in the same, um, time period, and the same life. And the idea is that you do good on both sides. You do good to each other, and we have many wampum belts. From the time of the fur traders and beyond and our interactions with government. So, it’s. .. a way [of] showing mutual respect.

These examples illustrate how indigenous and traditional practices can be integrated into counseling approaches. India reports the value of cultural applications to counseling values and expresses discomfort because of the dissatisfaction with direct applications of Western models. India explains how counseling models did not always answer questions people in the culture carry: “When we were working with people, we needed to indigenize, we needed to look at it, contextualize it, adapt models to contextualize it, and that is what I kept doing all my, through my years of my teaching.” The work of contextualizing appropriately still eludes the counseling profession at times. Canada concurs, “I would say that [contextualizing] kind of goes with the first nations and indigenous communities as well. You know, it is hard to get culturally appropriate responses from. . the counseling profession.”

Professional counselors also identify indigenous leadership structures as important in many traditional models of helping. Zimbabwe describes ways in which counseling services benefit from engaging leadership structures, because “It has also been provided by community leaders here, I mean the chiefs, the headman, we have those structure in villages here. And also respected members of communities. . [have] traditionally been providing counseling.” Similar to this experience, Iran describes, “before professional counseling coming to Iran, a lot of people would consult with wise man in their family. . still, they are very strong in that area. . [and one] would find some wise people in your area in our area.”

Samoa describes how counseling values relate to Samoan culture in the area of listening, because the experiences and assumptions of the traditional culture place a strong emphasis on the leaders simply giving advice while people listen. This can be very different from a counseling approach, and having the counselor in the role of listening may present a different experience altogether. According to Samoa:

It’s [counseling] moved away from advice giving. It’s kind of always been about advice from someone to another person and often from fathers, chiefs, ‘matai,’ who lead families. It’s more about the instructions towards everyone else. The way things are moving in Samoa people are starting to want to be more part of decisions that affect their lives.

Person-Centered Safe Spaces

Several participants (44%, n = 7) discuss person-centered safe spaces as central to valued counseling approaches. The participants describe the key elements of this theoretical approach in terms of the benefits provided to the culture. Australia explains, “The values around person-centered and relational and just letting people, the talking therapy of letting people, tell their story and being encouraged to wonder about this or expand on that.” Australia also reflects on more formalized descriptions of person-centered approaches:

I guess counseling across Australia taps into the amazing work of, say, Carl Rogers. So the values coming forward around unconditional positive regard, empathy, congruence, they’re very solid ways of working with people, the relational ways of working with people in our country.

Malawi describes some of the ways counselors can meet the needs of clients, including economic, religious, and sexual orientation differences, in a person-centered manner by exercising acceptance regardless of identity. Malawi explains the value of accepting others unconditionally in whatever need they present: “I think it implies very acceptances is the issue, that is a key word here. Because, like I say, the area shapes somebody and determines their world view, or world view determines who they are.” Mexico also describes some of the ways person-centered approaches help people feel accepted and meet their needs by creating this safe atmosphere in counseling:

I think that counselors can really meet those [counseling] needs, just by giving a space for people that is not available anywhere else. . .. It’s the only place I feel safe, is the only place where I can express these. It’s the only place where I feel I’m understood and that I actually am heard. . .. So that people can find that that relief and that safety that they’re looking for. And that, I think that’s what Mexicans need the most from counseling, just feeling safe, feeling heard, and finding alternatives.

The principles of person-centered theory seem to be applied to counseling among the participants in ways that expand beyond original Western applications. India describes ways of counseling individuals with person-centered approaches, but emphasized that applications of these approaches must go beyond just the individual. India clarifies, “Of course we use person-centered approaches, but we use more family-centered approaches. And that has been found much more useful.” To further illustrate the point, India explains, “I was counseling women in marital conflict at a shelter for women. And I did that for two years and we used not only individual person-centered counseling, but we also used group-centered counseling.”

Uruguay describes ways in which the closeness of the counseling relationship in a shared space offers an important way to conceptualize counseling in the country. The notion of contact carries a nuance in the country that highlights further meaning with counseling. Uruguay illuminates how the culture carries a “very particular characteristic of being proximal, being close and intimate. It’s something that Uruguay gives to counseling but it’s something that counseling brings to Uruguay—bringing these concrete space[s] where we can be close and intimate.” Uruguay describes practical applications in the school setting, where there are programs designed to increase contact:

.. . but not only the dialogue and the chance of generating a deep meaning contact, not only speaking or rationally understanding that we are connected, but through other means of contact and doing things more experiential than only rational or academic, where the living experience of meeting with oneself—students, counselors—all that from the theorical framework that the focus of person-centered approach and the Gestalt offers.

Creating safe spaces remains a highly important endeavor among the participants. Trinidad details the importance of establishing a person-centered approach in the spaces they create for clients: “I set up a safe, empathic, non-judgmental space for young people because they were being branded as no good.” In organizations and agencies that treat mental health, these principles are reinforced among those providing direct care. The ability to teach empathy skills was extended beyond counselors and mental health workers to reinforce safety and awareness of child development among parents, family, and the overall population of Trinidad and Tobago. Trinidad further clarifies, “I opened this space where young people can come and, you know, talk about their dreams and their hopes and their fears, and what have you.” The importance of this application becomes a key area of support. Trinidad concludes, “Counseling is so necessary. We need safe spaces for young people to come in.”

Wales presents similar thoughts with supporting general awareness of person-centered counseling applications, emphasizing how the general public can benefit greatly by recognizing and practicing some of the core principles of active listening. The contributions of counseling values within the culture provided benefit, as Wales emphasizes:

One of the things that, that really has grown exponentially is this whole idea of listening in our culture. That you know, not everybody needs to see a trained counselor, but to have somebody who’s really good at listening, and there’s a modern listening skills courses now for people who aren’t counselors. But they just go on these courses to learn how to listen more and realizing that just being a listening ear can be very healing for some people, you know.

Discussion

The research team uncovers clear themes expressed regarding counseling values by this diverse group of participants located all over the world. These participants from 16 countries, scattered throughout the globe, offer depth to the conversation of counseling values, and the data in this article focus on ways counselors can recognize valued approaches throughout the world. The results reflect prominent themes of the study, which included marital and family counseling, child and school counseling, faith integration, indigenous practices, and person-centered safe spaces.

The demographic data deliver helpful insights to the knowledge and expertise represented. Two qualified experts in the field of counseling for each of the eight global regions of IAC demonstrated skilled knowledge as counselors, leaders, professors, researchers, and supervisors that provide important insights to the profession internationally. The data reflect advanced degrees, mostly with ten or more years of professional experience, national licenses and certifications, and a variety of leadership roles.

Direct Applications

Applying the knowledge of this study offers a promising direction for global mental health counseling. The identified content areas described in the study provide helpful pillars of counseling values on which further intentional leadership and strategies that may enhance global mental health support. Conceptualizing applications of these data yield three main areas we propose for meaningful and practical applications with those wanting to make a difference in the mental health needs around the world. These applications are summarized as transcultural counseling training, resource adaptability, and bilateral development.

Transcultural Counseling Training

IAC (2022c) launched a transcultural counseling course that offered helpful insights to multiple layers of counseling intervention from countries all over the world. In a similar way that this study integrates input from professionals, this model of exploring transcultural principles in counseling offers a helpful direction for counseling professionals to enhance their awareness of cultural applications applied across cultures. Counselors can utilize this training to develop greater awareness of transcultural principles that transcend culture and identity across individuals, groups, and identities.

The results of this study offer a clear path of training that will enhance counselor awareness of transcultural issues. Professional counselors or counseling programs that wish to advance their knowledge and impact on international counseling can benefit from recognizing the valued approaches described in this study. The development of greater transcultural counseling skills regarding the valued approaches may require specific training in marital and family counseling, child and school counseling, faith integration, indigenous practices, and person-centered safe spaces. Counselor education programs can work to include these approaches, and the Council for Accreditation of Counseling and Related Educational Programs (CACREP, 2016) may consider including the items in future curriculum development. These areas can be understood and applied in a variety of ways depending on the context, such as India’s expanded use of ‘person-centered skills’ with broader group or family interactions.

Many opportunities for engaging international counseling training and experience exist in a variety of venues for clinical mental health counselors. IAC (2022c) continues to advance global efforts through leadership, education, collaboration, and advocacy, and there are frequent opportunities to volunteer for the many initiatives, including research, conferences, and collaboration, taking place throughout the world. The National Board for Certified Counselors (NBCC, 2012) provided similar experiences to enhance international capacity building for the counseling profession. They currently detail professional activities that develop international knowledge through partnerships, education, and service-learning experiences. Other opportunities to enhance transcultural counseling knowledge are through collaborative initiatives for mental health through WHO (2022) and the United Nations (UN, 2022). These resources offer practical ways for professional counselors to increase knowledge and competency with transcultural counseling development.

Resource Adaptability

Counselors have the opportunity to increase knowledge in these valued areas identified throughout the world, but there remains a need for ongoing adaptability among the approaches. Even with identifying the these important themes, the data reflects how this must be understood differently among various cultures. Counseling professionals can be ready to adapt skills, theories, and techniques to appropriately meet the needs of the individuals, groups, and communities they serve.

The research shows a strong focus on person-centered approaches that create safe spaces for people in the counseling room. This aligns with many comments from the literature about how counselor traits and characteristics are far more important than the skills they present (Bojuwoye, 2001; Perron et al., 2016; Srichannil & Prior, 2014). Counselors have a myriad of opportunities to creatively adapt counseling concepts and practices to the appropriate context in which they are offering services. This study proposes an adaptive approach to utilizing counseling knowledge is key for adjusting to needs with marriage and family, child expectations, faith integration, indigenous practices, and person-centered safe spaces. The literature highlighted ways in which this process of adapting well can begin with efforts to enhance counselor self-awareness and development (Chen & Hsiung, 2021; Hook & Vera, 2020).

Bilateral Development

The research questions of the study were designed to invite cultural insights that may contribute to global professional counseling development. Many insights from the participants reflected ways in which the counseling profession offers benefit to the culture discussed. In a similar manner, the cultures represented in this study contribute to understanding mental health support across cultures, and counselors can benefit from this bilateral perspective on professional counseling development.

Counselors can work to advocate for international counseling benefits different contexts, but counselors can also continue developing the profession based on input from the practice of these international counseling professionals. Counselors can explore concepts foreign their experiences that may enhance the impact of their counseling further. In a similar way, Ægisdóttir and Gerstein (2005) advocated for the need to incorporate indigenous philosophies into counseling practices to increase flexibility and adaptability. This was evident in the way the participants of this study highlighted nuances with the roles of family, marriage, parenting, and children. Encouraging counselors to learn foreign concepts can enhance development within any cultural context, and these concepts can enhance awareness, knowledge, and skill for serving a variety of people and communities in every country (Duff & Bedi, 2010; Hook & Vera, 2020).

Limitations

Part of the design for this study was that all the participants were connected through international associations, and all of them were identified through IAC. Associations attract counseling professionals that are drawn to similar interests, so the team acknowledges some responses may have been different with international counseling professionals that are not connected through the same association. Expanding the research beyond this particular group may help further inform the nuances presented in the data, and such expansion may help reduce biased impressions from a homogenous group.

Though the research design provided participants stratified throughout the world, having only two perspectives per region, or one perspective per country, offers only a limited perspective within that region or country. Each country and region no doubt carries many cultures, ethnicities, and people groups that consider mental health and wellbeing differently, and future studies may expand the search for counseling values within each region or country for greater precision of information.

Language is such a vital component of communication. The application and reviewing of the content may have carried nuances that remained unrecognized by the research team. Because English was a second language to most of the participants (and two included translation), the ability to capture all points of emphasis has the potential to be lost. The research team acknowledges the potential for this bias in the research, coding, and conceptualization process. Efforts were made to minimize researcher bias by including a blind review process of coding and verifying the use of each member’s material through participant checking, but even these processes include the potential for miscommunication or misinterpretation.

Conclusion

This study explored the common values of professional counseling that exist among counseling professionals in a wide variety of international cultural contexts. The research questions offer a broad lens from which participants could identify and define the values they recognize within their cultural contexts. An organized system of diversifying findings offered great depth to the conversation about enhancing cultural awareness and practice for counseling professionals wanting to see international counseling develop. The results provide valuable insights to understanding four categories of knowledge for counseling professionals, including: (1) Recognizing valued approaches, (2) Adapting to community settings, (3) Understanding common professional issues, and (4) Maximizing cross-cultural practices.

Due to the depth and detail of content, we desired to enhance the voice of the participants to focus attention on the first concept: recognizing valued approaches to counseling. This content relays the participants’ insights to consider approaches to marital and family counseling, child and school counseling, faith integration, indigenous practices, and person-centered safe spaces. Understanding these concepts provide opportunities for counselors to enhance development, both individually and professionally. Counseling professionals throughout the world are encouraged to apply these concepts by engaging further transcultural or international counseling training, creating resource adaptability, and committing to bilateral development of the profession across all cultures and contexts.

The remaining findings from this study will be shared in future articles. We believe the results of this study spotlight many areas of future research that can advance the discussion of international counseling issues further. The study provides a starting point to increase the conversation around international needs and issues as they relate to the mental health and counseling professions. Future research may replicate the qualitative method described for this study, and explore the insights of professionals across other associations. Additional studies are encouraged to explore the nature of counseling or mental health professionals in different countries and recognize what areas of education best advance counselor effectiveness in each setting.