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There are three major models of cultural value orientations we are going to mention for our training course: 1) Kluckhohn and Strodtbeck's Dimensions of Value Orientations; 2) Hall's Dimensions of Cultural Value Orientations; and 3) Hofstede's Five Dimensional Model of Values. We will also briefly touch on Milton Rokeach's work from The Nature of Human Values.

The primary point in all of these models is that all cultures face similar challenges of internal and external adaptation, and draw from a similar set of raw materials to find successful ways to adapt. However, the conclusions reached by different cultures can manifest themselves in very different forms.

Kluckhohn and Strodtbeck (16) suggest that there are six ways in which cultures will frequently differ in terms of key themes or ideas. Their Dimensions of Value Orientations include the following items:

- The Nature of the Individual: Is an individual primarily good, evil, or a mixture of the two? Is it possible for a person to change his/her nature, or is that nature fixed and immutable?

- The Relationship of People to their World: Is the relationship one in which people dominate the world, operate in harmony with the world, or subjugate themselves to nature?

- Individualism versus Collectivism: Does the group exist to support the individual or does the individual exist to support the group?

- Doing versus Being: Is a person's life journey about doing and accomplishing, or is it to simply be - and to enjoy one's time on this planet?

- Time Orientation: Does the culture evaluate its plans in terms of following custom or tradition based upon time tested ideas from the past, or does the culture think in terms of creating a better future?

- Space Orientation: Does the culture view space and property as fundamentally private and belonging to individuals, or as fundamentally public and belonging to all equally?

The manner in which a culture adheres to these different elements fundamentally shapes the world view of the people within that culture, according to Kluckhohn and Strodtbeck. (16) A culture that believes people are fundamentally evil and flawed from birth will have very different approaches to personal and social relationships than a culture that views people as fundamentally good.

A culture that believes in living one's life as a journey of being, in harmony with the world, will have very different ideas about such things as personal growth, individuation and the accumulation of wealth than will a culture that believes people should compete with each other and try to dominate the planet and rival competitors in competition for the world's resources.

Western Civilization tends to make very specific choices about each of these dimensions, and this affects a great many things in how people from Western cultures approach life. When these value dimensions are superimposed upon different cultures, there may be fundamental conflicts generated in the interaction.

Hall's (12) dimensions add a number of other concepts, addressing three important areas of culture: Context, Time, and Message Speed. His ideas are that cultures exist in the following dualities:

- High Context Cultures versus Low Context Cultures

- Monochronic Time versus Polychronic Time

- Fast Message Speed versus Slow Message Speed

In High Context cultures, more of the meaning of messages between people is encoded in the environment and the context in which people are interacting. This means that verbal or written communications cannot be taken just at face value, without taking into account the context in which the message is being presented.

For example, in certain high context cultures, there tend to be clearly prescribed rituals for situations, where not much needs to be said for everyone to understand what is going on and what is being communicated. The rituals themselves hold the meaning, and the words do not comprise a great deal of that meaning.

In Low Context cultures, communication is much more contained in the actual verbal messages that are passed back and forth. People in low context cultures do not focus as much on the context, nor have as many parts of the meaning defined by rituals or pre-determined messages embedded in the context.

People from low context cultures tend to struggle with understanding communication with people from high context cultures. Much of the meaning is encoded in the situation, and people from low context cultures often do not understand the context or know how to read the cues embedded in the rituals and protocols.

In Monochronic Time, events occur discretely, one at a time, according to schedules that are understood the same way by all parties. In monochronic cultures, it is very important to be punctual. Monochronic cultures tend to run on schedules by the clock.

Polychronic cultures, on the other hand, tend not to see - or value -time in the same way. It may not be very important to be prompt, because all events occur in the midst of other, equally important activities, with a greater sense of flexibility and freedom from schedules.

Clinicians, who tend to set very fixed schedules in order to accommodate the greatest number of clients might have difficulties in working with clients who come from polychronic cultures. Clients from polychromic cultures may show up late and not understand why the clinician cannot see them when they arrive.

Fast Message Speed cultures tend to transmit and receive messages quickly, and respond to them equally quickly. Fast message speed cultures are more likely to be monochronic. They want things to be done more quickly, so they impart their communications with a sense of urgency that slow message speed cultures do not have.

In slow message speed cultures, messages are designed to unfold slowly, with layers of meaning that become apparent as the message develops over time. The messages would be responded to in a deliberate and careful manner.

Because these elements are so deeply embedded in the cultures that hold them, it can be difficult for someone coming from a different culture to grasp the meaning and importance or the elements. It may be difficult for a person from a different culture to even see some aspects of these elements, as if they were completely invisible.

Clinicians are advised to pierce through this veil of invisibility when working with clients from different cultures. Only through understanding their orientation towards the world can you hope to work with them in ways that turn out to be ethical and responsible.

Hofstede's Five Dimensional Model of Values (15) was derived from examining business and work relationships. He describes five different areas of difference between cultures in their work environment:

- Power Distance

- Individualism versus Collectivism

- "Masculinity" versus "Femininity"

- Uncertainty Avoidance

- Long versus Short Term Orientation

Power Distance is concerned with the degree to which it is expected that people in positions of authority will wield greater amounts of power and authority. In high power distance cultures, subordinates do not expect to be allowed to challenge the decisions of people in positions of authority. Low power distance cultures are more egalitarian in the distribution of power and authority.

Hofstede's understanding of the continuum of Individualism versus Collectivism is similar to that of Kluckhohn and Strodtbeck. Some cultures are oriented towards individual rights at the expense of collective responsibilities, while others are oriented towards few individual rights and a high degree of collective or community responsibilities.

The United States was founded as an experiment in seeking individual rights and Western based market cultures tend to champion those rights at the expense of taking care of common interests and collective responsibilities. This contrasts with many other cultures in which the individual exists to serve the well being of the community.

"Masculinity" versus "Femininity" (please note the quotation marks, denoting that these are not meant to be taken literally) is concerned with the degree to which a culture promotes values of aggressiveness and excelling in competition, versus caring for other (and weaker) members of the culture, as well as the overall quality of life.

Uncertainty Avoidance has to do with the degree to which cultures try to avoid unclear or ambiguous situations. Cultures that have a high degree of uncertainty avoidance tend to have many formalized rules and rituals that allow its members to know how to approach personal interactions. Cultures that tolerate uncertainty more easily are able to improvise personal interactions more flexibly.

When persons from low uncertainty avoidance cultures interact with persons from high uncertainty avoidance cultures, there can be a great deal of misunderstanding and tension created. Typically, the person from the culture with low uncertainty avoidance will need to learn the rules and rituals of interaction, so that the uncertainty can be kept at a manageable level for the benefit of the parties with high uncertainty avoidance.

Hofstede's final dimension is concerned with Long-term versus Short-term Orientation. This is the degree to which a culture tends to operate with a long-term view of the world and the role of its members in the great sweep of history, as opposed to a short-term, narrowly focused sense of time.

One of the more frequently told stories of the differences between cultures in this dimension references the time when representatives from the United States were meeting with representatives from North Viet Nam to hammer out a solution to the war in Viet Nam. The US delegation found living quarters that they could lease on a month by month basis. The Vietnamese delegation bought a house.

The orientation of the Vietnamese was that whether the peace came in the lifetime of the representatives, or a hundred years forward, they needed to create peace terms that would work with their sense of history, with a very long-term orientation in a country that had a very long history and a sense of connectedness to that history. The United States was looking forward to the next round of elections.

Which of these ways of approaching the world is "right" and which is "wrong"? Are societies in which individual rights are championed better or worse than societies in which members are willing to sacrifice their individual well-being for the good of the community?

These are important questions when the ethical role of the mental health clinician involves helping the client move from a place that is worse to a place that is better.

Let's add the final few pieces of knowledge to the mix before we move forward in trying to examine these questions. Let's look at the work of the late Milton Rokeach, a professor of psychology and an influential examiner of beliefs and values.

Dr. Rokeach analyzed the different ideals held out by different cultures. From his study of different cultural values, he suggested that all cultures drew from a common pool of ideals when determining what are the most important values within their culture. However, each culture rank orders these ideals in different ways, based upon their systems of values and beliefs. Let's look at the list that he proposed. (25)

Rokeach's Personal Characteristics

1. Self-controlled (thinks first, restrained, self-disciplined)
2. Honest (sincere, truthful, disclosing)
3. Loving (affectionate, tender, caring)
4. Ambitious (hard working, aspiring)
5. Cheerful (light hearted, joyful)
6. Responsible (dependable, reliable)
7. Independent (self-reliant, self-sufficient)
8. Broad minded (open minded, flexible thinker)
9. Polite (courteous, well mannered)
10. Forgiving (willing to pardon others)
11. Intellectual (intelligent, knowledgeable)
12. Helpful (working for the welfare of others)
13. Obedient (dutiful, respectful)
14. Capable (competent, skillful)
15. Logical (consistent, rational, aware of reality)
16. Courageous (strong, willing to stand up for beliefs)
17. Imaginative (daring, creative)
18. Clean (neat, tidy, well organized)

There are cultures in which obedience and self-control are the highest virtues, while in others independence and imagination are viewed as being more important. Whichever ideals are forwarded, it will shape the culture and its members in important ways. It will also help determine the definitions of what "normal" or "deviant" behavior will be, as well as what values and behaviors each individual is supposed to aim for in order to reach a congruent sense of self within their cultural framework.

If a clinician is superimposing a different cultural framework on the client – trying push the client to aim for different ideals of virtue, values, and behaviors – it raises some difficult questions about whether the clinician is helping the client move to a better (or even more adaptive) place.

In addition to these larger perspectives on values, there are also areas of perceptions and beliefs that differ greatly from culture to culture. Cultural differences in such emotionally loaded areas as sexuality, sexual orientation, family structure, death and dying will show up frequently in cross-cultural counseling. Because they are able to raise powerful feelings, they will pose considerable difficulties for the clinician – both in terms of finding workable and adaptive solutions that help the client and in terms of managing one's own biases and emotional responses in a responsible and ethical way.

Because there are so many different ways of conceptualizing these ideals, the clinician's ethical task is more complicated. It requires the clinician to find a process for arriving at conclusions that make sense for the individual within the counseling relationship within the cultural framework in which the counseling takes place.

The subject matter of the next section will be concerned with beginning to outline the framework for this process.