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our clients, we avoid stereotyping and keep the focus on the client’s specific needs”
(Steinberg Warren n.d.). Steinberg Warren and Wilson ( 2013 ) note that as genetic
counselors, “We use empathy in all genetic counseling sessions to understand the
client’s experiences, emotions, and perceptions of the world, and we determine how
our client’s behaviors and decisions are influenced” (p. 7).
Given growing attention to and awareness of cultural differences, some
authors further refine the concept of empathy. Ridley ( 1995 ; Ridley and Lingle
1996 ) coined the term “cultural empathy” to describe empathy that is sensitive to
patient culture in psychological counseling. Cultural empathy is based on three
principles:
- Every patient should be understood from her or his unique frame of reference.
- Normative information (e.g., data about what people do on average, statistics
about the typical person) does not always fit a particular patient, although it can
be useful as background information. - People are a dynamic blend of multiple roles and identities.
Cultural empathy occurs when counselors demonstrate and communicate “an
understanding of the client’s worldview and [acknowledge] the cultural differences
between them” (Chung and Bemak 2002 , p. 155). Cultural empathy involves two
components—understanding and responsiveness:
Cultural empathic understanding entails:
(a) Cultural self-other differentiation—examining your own cultural identity and
values and learning about the patient’s cultural identity and values. Chung and
Bemak ( 2002 ) note that “...one of the major cognitive tasks in achieving cul-
tural empathy is for counselors to differentiate their cultural self and their strong
cultural biases from those of their clients” (p. 157).
(b) Perspective-taking—developing an understanding of the patient’s culture and
using this understanding to see the patient in his/her cultural context.
(c) Probing for insight—collecting information about the patient’s entire self-
experience and asking clarifying questions. (Open-ended questions, discussed
in Chap. 5 , can be useful.)
Cultural empathic responsiveness entails:
(a) Conveying interest—in learning more about the patient’s cultural values (e.g.,
“Tell me more about how this is viewed in your culture”)
(b) Expressing naïveté—with respect to the patient’s cultural experience (e.g.,
“What is it like for you as a member of this religious community?”)
(c) Verbally disclosing—to the patient your understanding of the patient’s self-
experience (e.g., through paraphrasing, reflecting, summarizing)
Chung and Bemak ( 2002 , pp. 157–158) recommend that counselors:
- Affirm their patient’s cultural experience.
- Clarify language and other cultural communication modes.
- Express a desire to be helpful.
- Understand and accept the context of a patient’s family and community.
4 Listening to Patients: Primary Empathy Skills