Single case study the grieving filipino boy

Addressing Spiritual Issues From a Cultural Perspective: The Case of the

Grieving Filipino Boy

Kathryn P. Shimabukuro Judy Daniels

Michael D’Andrea

This article examines the ways that spiritual beliefs and traditions associated with the Filipino culture influenced an 1 I-year-old boy’s efforts to cope with the death of his mother. Implications for attending to clients’ spiritual beliefs are discussed.

Researchers have noted that most people in the United States have some sort of spiritual identity (Gallup & Castelli, 1989; Kelly, 1995). The term spiritual identrty refers to the manner in which a person’s spiritual beliefs influence their self-definition and the way that person constructs meaning of life (D’Andrea & Daniels, in press). Although a person’s spirituality clearly plays an important role in the psychological development of many ifnot most people in our modem society, it is curious that this issue has not been extensively addressed by counseling theorists and researchers in the past. Recently, however, a number of persons in the profession have demonstrated increased interest in understanding how issues related to spirituality affect human development. To gain an increased understanding of the ways in which spirituality influences an individual‘s psychological development, it is important to first define what we mean by this term. In attempting to define this construct, Albanese (1992) pointed out

that the term Spirituality has been commonly used to refer to “extraordinary” experiences that go beyond the boundaries of the strictly objective, empirically perceived material world. Kelly ( 1995) built on

Kathryn P. Shimabukuro is aprofessional school counselor a t Nimitz Elementary S c b l in Honolulu, Hawaii Judy Daniels and Michael DAndrea are both professors in the Department of Counselor Education at the Uniuersity of Hawaii Honolulu Correspon- dence regarding this article should be sent to Michael D’Andrea, Department of Coun- selor Education, 1776 University Avenue, Uniuersity of Hawaii Honolulu, HI 96822 (e-mail: Michael@hnwaiiedul.

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this definition by noting that the concept of spirituality is typically “grounded in an affirmation of the transcendence or ‘otherness’ that is reflected within the boundaries of everyday culture and is commonly manifested in identifiable religious forms pointing beyond the boundaries of the ordinary and tangible” (p. 3). Other writers have pointed out that the term spirituality refers to the belief in a reality that transcends the physical nature of the world and provides individuals with an “extra-ordinary’’ meaning of life in general and human existence in particular (Gartner, Larson, & Allen, 199 1; Giblin, 1996). As used in this article, the terms spirituality and spiritual identity

refer to the unique ways that people integrate their beliefs about a transcendental, extraordinary reality into their worldview and personal identity. This may include but is not limited to their beliefs about the afterlife, the interconnectedness of all things in the uni- verse as well as their views about the meaning of such concepts as God, enlightenment, and grace (DAndrea & Daniels, in press; Ivey, Ivey, & Simek-Morgan, 1997). Kelly (1995) and key et al. (1997) stressed that it is important for

counselors to address clients’ spiritual beliefs in counseling because they often influence (a) the way individuals construct meaning of life events and (b) the coping strategies individuals use to deal with various challenges/problems they experience in their lives. Given the important role that spirituality plays in many people’s lives, it is dis- turbing that counselors often avoid dealing with their clients’ spiritual beliefs in clinical practice (D’Andrea & Daniels, in press; Kelly, 1995). There are at least four factors that have historically led practitioners to avoid dealing with spiritual issues in counseling. First, most contemporary counseling theories do not address the

ways in which spirituality influences clients’ psychological development. For example, although (a) psychoanalybc counseling commonly directs attention to clients’ unconscious dynamics (Freud, 1955; Malcolm, 1986), (b) Rational Emotive Behavior Therapy focuses on individuals’ irrational beliefs (Bernard, 199 1; Ellis & Grieger, 1986). (c) behavioral counseling strategies emphasize behavioral contingencies (Glass & Arnkoff. 1992; Spiegler & Guevremont, 1993). and (d) the person-centered approach encourages practitioners to demonstrate unconditional regard, congruence, and empathic understanding to foster positive clinical outcomes (Cain, 1990; Rogers, 19861, these traditional counseling theories direct little attention to the role spirituality plays in promoting clients’ psychological health and sense of personal well-being. Second, counselor education programs gener- ally do not train counselors to deal with clients’ spiritual identity in

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the context of individual or small group counseling settings (Ivey et al., 1997; Kelly, 1994). Third, as a result of being inadequately trained in this area, practitioners often fail to thoroughly explore the ways in which clients’ spiritual beliefs are used to construct meaning of their lives (Julian, 1992). Fourth, most counselors are not knowledgeable of the different spiritual beliefs and traditions that people from culturally diverse backgrounds use to cope with the challenges and problems they experience in their lives (Ivey et al.. 1997; Lee & Armstrong, 1995; Richardson & June, 1997).

This article reports on the results of a cross-cultural case study in which a young, Filipino student was experiencing difficulty coping with the death of his mother. By using a qualitative/phenomenological approach (Houser, 1998; Yin, 1984) to study this client’s reactions to his mother’s death, the first author was able to (a) better understand how this youngster’s spiritual-cultural beliefs influenced his reactions to his personal loss and (b) use these newly acquired insights to promote positive outcomes in a cross-cultural counseling context. Although some traditional counseling researchers are likely to criticize a case study that involves only one subject arguing that the results of such investigations have limited generalizability, multicultural counseling advocates have noted that this research approach often provides useful and in-depth information about important psychological issues that characterize people from diverse cultural-racial backgrounds (Sue, Ivey, & Pedersen, 1996; Yin, 1984). Thus, although the generalizabilty of the findings of single subject case studies are limited, the in-depth information that can be gen- erated from this research methodology provides counseling professionals with much information that can be helpful to keep in mind when working with people from diverse backgrounds. Furthermore. because many people from non-White, non-European backgrounds “are reluctant to participate in any activity that smacks of experi- mentation” (Atkinson, Morten, & Sue, 1990. p. 335), the case study research approach represents a less intrusive research methodology that can increase our understanding about issues related to spirituality in multicultural counseling situations.

THE IMPORTANCE OF ADDRESSING SPIRITUAL ISSUES IN M U LTI C U LT U R A L C 0 U N S E L I N G SIT UATl 0 N S

Kelly (1995) synthesized the results of several national polls that revealed that the vast majority of people in this country adhere to various beliefs about spirituality. These polls also indicated that many people rely on their spiritual beliefs when confronted with personal


challenges or problems that occur in their lives. Although spirituality serves important psychological functions among many people in the general populace, several multicultural experts have stressed that spiritual issues play a particularly important role in the psychological development of people from diverse ethnic-racial groups (Atkinson et al.. 1990; Georgia, 1994; Ivey et al., 1997; Julian, 1992; Lee & Armstrong, 1995; Pate & Bondi, 1992; Sue et al., 1996). For instance, it has been reported that a strong and all-encompassing belief in the spiritual realm plays a central role in Native American psychology (Garrett & Garrett, 1994). Shonis (1992) discussed how spiritual beliefs influence the worldview of many Latinos/Latinas. Other multicultural researchers described how spirituality in general and the Black Church in particular have historically contributed to promoting the mental health of African Americans in the United States (Richardson & June, 1997; White & Parham, 1990). I t has also been noted that many people from Southeast Asian coun- tries reject western approaches to counseling and psychotherapy in favor of native healing practices that are rooted in traditional spiritual beliefs and traditions (Chung, Bemak, & Okazaki, 1997). Although spiritual beliefs and traditions play an important role

in the psychological development of people from diverse cultural- ethnic-racial backgrounds, it is distressing to note the lack of attention that has been directed to this aspect of human development by counseling theorists, researchers, practitioners, and educators. In light of the rapid cultural diversification of the United States (Sue et al.. 1996) and recognizing the important role that spirituality plays in the lives of people from diverse cultural-ethnic backgrounds, counselors need to acquire competencies that will allow them to address their clients’ spiritual identities effectively and ethically in the fu- ture (DAndrea & Daniels, in press; Sue, Arredondo, & McDavis, 1992). These competencies include the following:

1. Becoming aware of the ways in which the practitioner’s own biases about spiritual traditions and beliefs may complement or compromise effective counseling

beliefs and traditions that characterize people from diverse cultural backgrounds

3. Acquiring the skills that are necessary to effectively incorpo- rate one’s awareness and knowledge about clients’ spiritual identities into the counseling process in ways that reflect a heightened sensitivity and respect for this important dimen- sion of human development (D’Andrea & Daniels, in press)

2. Increasing one’s knowledge about the different spiritual


This article is designed to increase counselors’ competencies in these areas by examining how Filipino spiritual beliefs and traditions influence the way a fifth-grade Filipino boy coped with the psychological stress that was associated with the death of his mother. More specifically, the following sections describe

1. How this youngster used culturally specific coping strategies that were linked to his spiritual beliefs to deal with the loss of his mother

2. The actions his counselor (first author) took to increase her awareness and knowledge of Filipino spiritual beliefs and traditions especially as they related to the ways in which many Filipinos cope with the death of a loved one

3. The implications of acquiring this new knowledge for counseling practice

It is important to emphasize that without such knowledge counselors may pathologize behaviors that, although appearing unusual to the culturally incompetent practitioner, are very appropriate from the client’s own cultural perspective (Lee & Armstrong, 1995; Sue et al., 1996). By discussing the case of the grieving Filipino boy in the following sections of this article, it is our hope that counseling practitioners will (a) gain an increased understanding of the complex ways in which culturally based spiritual beliefs and traditions affect individuals’ lives in general, and (b) specifically how such beliefs and traditions influence the way Filipinos commonly cope with the death of loved ones.

The Case of the Grieving Filipino Boy

Filipinos not only represent the second largest Asian group in the United States but one of the fastest growing immigrant groups in this nation (Root, 1997: Salvador, 1996). Although counseling practitioners’ chances of working with people from Filipino ancestry increase each year, many counselors are not knowledgeable of the unique beliefs, traditions, and values that characterize individuals from this cultural-ethnic population. Although lacking in-depth knowledge about people from this cul-

tural group, the first author was called on to provide counseling services to a fifth-grade male student of Filipino ancestry. At the time of his referral, this youngster was living in Hawaii and attending one of the public schools in a suburhan section of the state. The boy was referred by his teacher to the school counselor (first author)

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because he was not paying attention in class and repeatedly failed to get his schoolwork done. Although this youngster had been a good student in the past, his classroom behavior changed dramati- cally after his mother died unexpectedly. Despite the fact that his mother had died several months earlier,

this student continued to talk about how much he missed her. His teacher also reported that this youngster frequently appeared to be talking to his deceased mother while he was in class. On gathering additional information about this student, the school counselor learned that he was living with his father in what was described as an “un- stable family situation.” The counselor also learned that the student had a desire to live with his maternal grandmother: however, his father and grandmother lived in separate locations and did not always get along with each other. Although the student’s father and grandmother did consult with

the school counselor on a couple of occasions regarding the youngster’s grief reaction and academic problems, they did not demonstrate an interest in participating in ongoing family counseling or consultation interventions. Because of the infrequent contact that the school counselor had with this student’s father and grandmother, she was not able to assess the family’s level of acculturation. However, based on her observations of this student at school and as a result of working directly with him in several individual counseling sessions, the school counselor noted that this youngster demonstrated a fairly high level of acculturation (i.e., in the way he dressed and in his interactions with his peers) but also maintained a number of spiritual beliefs that are embedded in the Filipino culture.

Because this student’s father and grandmother were not willing to participate in ongoing family counseling and consultation meetings, the school counselor’s role in this case was primarily limited to providing supportive counseling services wih5 the student and consulting with his teachers about his academic work. These services were offered to support this young boy in the grieving process and to assist him in meeting his teachers’ expectations in the classroom. The counselor received permission from the student to tape-record

their individual counseling sessions. She explained to the youngster that by tape-recording their sessions she could listen to the topics that they covered in their meetings at a later time and get feedback about her counseling style from her supervisor. The following inter- action, which took place during the initial counseling encounter, is taken directly from a tape recording of the session that was later transcribed (Shimabukuro, 1995).

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Description of the fist counseling session with Mark la pseudonym). After welcoming Mark into her office, the counselor began the counseling session in the following manner:

Counselor: Your teacher is wondering if there’s something going on that is making it hard for you to get your work done or making it difficult to pay attention in class. Mark: [silence] Counselor: When you are in class what are you thinking about? Mark: Every time I’m writing it’s like my mother comes into my mind and it’s like she is talking to me and showing me what we were doing in class. It’s like a video replaying what we just did. Counselor: What does her voice sound like? Mark: It jus t echoes. Counselor: Do you feel like you are imagining her or do you feel like she is really there? Mark: J u s t like she is really there right next to me in class. She’s always there to protect me. At home, if my Dad comes in late and I have to feed the chickens, then my Mom always goes with me. Then after that she has to go back. yeah just like she goes back to someplace else. Counselor: So you really get protection and comfort from your mom. Mark: Yeah. Counselor: Where is your mom right now while we are talking? Mark: She is over here [the client gestures next to himselfl. Counselor: She’s right there? Is she in the chair? Mark: She’s kneeling down next to me.

Mark proceeds to talk about ghosts who have also visited him at his house. He goes on to explain that he knows that the ghosts are not his mom because she always stays close to him. He describes further how his uncle made a cross out of two swords and taped crosses on the windows to keep the ghosts out. However, when his uncle removed the crosses the ghosts came back. The counselor probed further to see how Mark felt about the ghosts. The youngster stated that he only gets scared if there are no adults around when he sees the ghosts. The counselor then questioned Mark to see if anyone in his family provided him with support about his feelings and experiences with his mom and the ghosts in his house.

Counselor: Who else have you talked to about your mom and the ghosts? Mark: Nobody. Counselor: Well, I am really glad that you are telling me. Mark: But my mom told me don’t tell anybody . . . but she did say that I could tell someone that I trusted. Counselor: How do you feel now that you’ve told me? Mark: Not s o lonely.

The counselor ended their initial counseling session by telling Mark that she would like to talk to him again about his mother so that they could figure out how his mom could be supportive but not dis-


tract him during school hours. Mark stated that he thought that was a good idea because he was having a hard time listening to his teacher in class. They agreed to meet again before the end of the week. Although the counselor had received training in multicultural coun-

seling as a graduate student, she did not have an extensive understanding of Filipino spiritual beliefs and traditions, especially as they related to the grieving process. Because she believed that there was a possible link between Filipino spiritud beliefs and the behaviors that Mark was manifesting in response to his mother’s death, she was hesitant to conclude that this client was demonstrating pathological behaviors. Rather, the counselor hypothesized that this youngster’s reactions to his mother’s death may have been grounded in various cultural beliefs and traditions about which she simply was not knowledgeable. Realizing the importance of becoming better informed about Filipino spiritual beliefs and traditions to work effectively and ethically with Mark, the counselor sought to learn more about Filipino cultural-spiritual beliefs particularly as they related to mourning the death of a loved one. Learning about the link between Filipino spiritual beliefs and mourn-

ing practices. In an effort to learn more about Filipino spiritual beliefs and practices (especially as they related to the ways in which persons from Filipino ancestry coped with a personal loss), the counselor (first author) immediately contacted a Roman Catholic priest in the Filipino community to discuss the student’s situation. Subse- quently, the counselor did an extensive review of the multicultural counseling literature in this area. Unfortunately, the counselor found very little information regarding the ways in which Filipino spiritual beliefs and customs influenced the mourning practices of Filipinos living in the United States. Most of the available information in this area was specific to people living in the Philippines (Vergara, 1986). This included information related to Filipino animistic belief systems (i.e., the belief in ancestral spirits and visitations from the deceased; Schieler, 1989). a description of culturally appropriate behaviors and feelings that are associated with the loss of a deceased loved one (Atuel, Williams, & Camar, 1988), and funeral and mourning practices that have been influenced by a combination of Christian and animistic traditions (Anima, 1978; Chan, 1984; Habenstein, 1974, Henry, 1986; Schieler, 1989). These efforts helped the school counselor better understand the ways in which animistic and Christian beliefs have historically coexisted among people in the Philippines (especially in rural parts of the country) even though the majority of Filipinos identify themselves as being Roman Catho-

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lics (Guthrie & Szanton, 1976). For clarification, as used in this article, the term animism refers to the belief in the existence of spirits and in their power to influence the world of the living. Because most of the data on Filipino spiritual beliefs and mourn-

ing practices related to persons residing in the Philippines, the school counselor conducted her own investigation of Filipinos living in Hawaii (Shimabukuro, 1995). What follows is a brief description of the school counselor’s research and findings in this area.

Conducting structured interviews with Filipino “experts. “To gain more knowledge about Filipino spiritual beliefs and the impact they had on the grieving process, Shimabukuro ( 1995) conducted a phenomenological study that involved (a) conducting an extensive review of the literature related to Filipino culture and traditions (Agbayani, 1991; Alegado, 1991; Bail & Mina. 1981; Bulatao, 1992; Chattergy & Ongteco, 1991). and (b) interviewing 12 persons considered to be “experts” in the Filipino culture who lived and worked in Hawaii. Six of these experts were professors at the University of Hawaii who had conducted extensive research on different aspects of Filipino culture. These individuals were affiliated with several departments at the university including the Departments of Anthropology. Ethnic Studies, Linguistics, Psychiatry, and Psychology. The counselor also interviewed six other “cultural experts” who

worked primarily with Filipino people in Hawaii. These individuals included a Catholic priest, two Catholic nuns (one of whom worked at a hospice), an educator, and two mental health professionals. Half of the 12 Filipino cultural experts selected for her study were originally from the Philippines. As a result of conducting this investigation, the school counselor gained a large amount of knowledge that was very useful in (a) helping her to more accurately understand her young client’s reactions to his mother’s death (Alegado, 1991; Atuel et al., 1988). and (b) helping her to plan intervention strategies that reflected greater respect and sensitivity for his cultural background, beliefs, and traditions (Agbayani, 199 l ; Bail & Mina, 198 1 ; Chattergy & Ongteco, 199 1 ) . This information included gaining knowledge about Filipinos’ spiritual beliefs about death (Demetrio, Cordero-Fernando, & Zialcita, 199 1). Filipino funeral rituals and mourning practices (Elesterio, 1989; Habenstein, 1974). and the ways in which Filipinos who live in Hawaii relate to deceased people (Jocano, 1982; Lin, Demonteverde, & Nuccio, 1990; Mercado, 1991: Murray, 1984). Spiritual beliefs about death from a €Xipino cultural perspective. In

conducting her interviews with the various cultural experts just mentioned, the school counselor learned that Christian and animis-


tic beliefs also coexist among many Filipino people who live in Ha- waii. For this reason, it is not uncommon for people from this cultural group who live in Hawaii to practice mourning rituals that include aspects of both of these belief systems in the grieving process (Bulatao, 1992; Elesterio, 1989). However, the experts who took part in her study did point out that Filipinos living in Hawaii tend to be more cautious about expressing animistic beliefs around Westerners (Chattergy & Ongteco, 1991). Christian religious beliefs were noted to play a key role in Filipino

culture because the experts explained that most Filipinos adhere to the notion of the existence of heaven and hell (Elesterio, 1989; Schieler, 1989). Unlike most Christian religious traditions that suggest that a person’s soul goes to heaven, hell, or purgatory (a spiritual realm that exists between heaven and hell) after death, Filipino spiritual beliefs provide three possible explanations as to what happens to one’s soul after death (Demetrio et al., 1991). According to the Fili- pino experts who were interviewed in the counselor’s study, it was explained that (a) a person’s soul may linger on earth for a period of time after death to watch over the individual’s living loved ones, (b) the deceased person’s soul may immediately ascend to heaven or purgatory, or (c) the person may possess two souls: one remains on earth to watch over loved ones while the other soul goes to heaven (Agbayani, 199 1 ; Chattergy & Ongteco, 199 1). Firipino funeral rituals. In conducting her interviews, the school coun-

selor learned that a combination of Christian and animistic spiritual beliefs is commonly manifested in Filipino funeral rituals. In the past, many Filipinos followed the Catholic tradition by holding a wake for the deceased loved one in their homes. In contemporary times, this ritual is more commonly held at a funeral parlor. Whether held in the family’s home or at a funeral parlor, the purpose of a wake in Filipino culture is to provide an opportunity for family members and friends to come together to pray for the deceased person to assist the individual’s soul on its journey to heaven (Demetrio et al., 1991).

Some of the cultural experts who were interviewed also stated that many first generation Filipinos believe that heaven is a physical place and, as a result, noted that it was not uncommon to find that they may bury personal items with the deceased person to comfort them in their journey to heaven (Vergara, 1986). After the burial, many Filipinos follow another Catholic tradition that involves reciting a special prayer for the deceased person that is called a “novena.” This novena is recited for nine consecutive evenings after the burial as a way of further supporting the deceased person’s soul on its journey to heaven (Agbayani, 1991; Chattergy & Ongteco, 1991; Vergara, 1986).

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In addition to following these Catholic traditions, many Filipinos use other rituals that are based on animistic beliefs, specifically the belief that spirits interact with the living. This includes the following: not sweeping the deceased person’s home until the burial is complete (to prevent the spirit from being swept away); talking to the deceased person’s spirit; experiencing visits from other spirits, angels, or ghosts; and performing cleansing rituals (Vergara, 1986). A cleansing ritual commonly takes place after the burial and typically includes family members who may have come in close contact with the deceased person’s body during the burial service. This ritual involves washing one’s face from a bowl that contains a mixture of vinegar and water to purify oneself after the deceased person has been buried (Demetrio et al., 1991; Vergara, 1986). Filipino mourning practices. As a result of conducting her inter-

views with the Filipino experts, the school counselor also learned about some of the typical mourning practices that Filipinos commonly exhibit after the death of a loved one. It was pointed out that bereaved Filipino family members usually wear black clothing, a black arm band, or a pin for a full year after the person has died to sym- bolize their mourning for the loss of the beloved (Alegado, 1991; Demetrio et al., 199 1). The interviewees explained further that Fili- pino families who live in Hawaii or the mainland United States are likely to keep grieving children out of school for a week or more after the death of a family member. However, if the death and funeral occurred in the Philippines, it was explained that children may be taken out of school for as much as a month to allow for a proper period of time to mourn the deceased person (Chattergy & Ongteco, 1991). To celebrate the formal completion of their mourning, Filipino fam-

ily members typically conduct a ceremony honoring their loved one on the first anniversary of the person’s death (Alegado, 1991; Mulholland, 1970). In following another Catholic tradition, many Filipino family members believe that it is important to also celebrate the deceased person by having a picnic at the grave site on what is referred to as “All Saints Day” and “All Souls Day” (2 days identified in the Catholic tradition as times in which deceased persons should be remembered and prayed for by family members and friends; Lin et al., 1990; Mulholland, 1970; Vergara, 1986). Relating to the deceased. The cultural experts who participated in

Shimabukuro’s (1995) study explained that it was a common and acceptable practice for people to maintain a connection with deceased loved ones in the Filipino culture. This is done in a variety of ways. For example, it was noted that family members typically bring pho-

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tographs of their deceased loved ones to family gatherings where they tell stories about situations involving these individuals when they were alive. I t was also pointed out that it is not uncommon for Filipinos to talk about deceased relatives “visiting” them. These visits may occur in dreams or during waking hours. Sometimes the deceased visitor is described as appearing as an angel (Alegado, 199 1 ; Demetrio et al., 199 1). Unexplained physical phenomena, such as the lights unexpectedly going out in one’s home, may be attributed to visits by deceased persons. The cultural experts also stated that some of the reasons these spirits are thought to visit family members include the desire for the spirit to communicate that it is happy in the spiritual realm; an effort to deal with an unresolved conflict with members of the family; or simply to remind loved ones that the deceased person should not be forgotten (Atuel et al., 1988; Murray, 1984). The experts in Shimabukuro’s (1995) study talked about several

spiritual beliefs that contributed to the view that deceased people’s spirits can and do visit loved ones after death. First, as was mentioned earlier, the animistic tradition that is strongly embedded in the Filipino culture reinforces the notion of the existence of spirits (Vergara, 1986). Second, emerging from the Catholic tradition, the concept of the guardian angel represents another prominent belief that exists in the Filipino culture (Lin et al., 1990; Vergara, 1986). Third, it was noted that Filipino parents commonly teach their young children that spirits exist and serve various purposes (Alegado, 199 1; Atuel et al., 1988). Fourth, some of the persons that the counselor interviewed stated that many Filipinos believe that children often act as mediums who are able to receive messages from the dead (Atuel et al., 1988).

Implications for Counseling Practice

I t is interesting that, although not intentional, the steps that the school counselor took in dealing with her young Filipino client follow a counseling framework that was described by Casas and Vasquez (1996). In their general counseling framework, Casas and Vasquez encouraged practitioners to follow three steps when working with persons from culturally diverse groups who adhere to belief systems, values, and traditions that are markedly different from their own. According to these multicultural experts, counselors are urged to “first become aware of the professional and personal influences, assumptions, and biases that determine and direct their interactions with clients from diverse backgrounds” (p. 156). By taking the


time to make this sort of self-assessment counselors are not only able to identify personal and professional biases that can lead to erroneous interpretations of their clients’ problems and behaviors, but they are also able to think about the limitations of their o w n knowledge of culturally different clients’ spiritual beliefs, traditions, and practices. Second, counselors are urged to assess how culturally different

clients’ assumptions, worldviews, beliefs, values, and behaviors result in unique ways of constructing meaning about life and (as was noted in the case study presented in this article) death. However, because many counselors encounter clients who come from cultural- ethnic backgrounds with which they have had little or no personal contact or professional training, practitioners are encouraged to consult with cultural experts who are a part of their clients’ indigenous support and healing systems (Casas & Vasquez, 1996). Third, after following the two aforementioned steps, Casas and Vasquez

(1996) suggested that counselors are in a much better position to tailor intervention strategies that reflect a greater level of understanding, respect, and sensitivity to their clients’ cultural-spiritual beliefs, values, and traditions. Furthermore, these authors acknowl- edge that clients who do not come from the dominant cultural-racial group in the United States often benefit from interventions that are designed to foster both intrapsychic and environmental changes. Thus, by using a multifaceted approach that requires counselors to go beyond simply providing direct counseling services, practitioners are encouraged to also work as advisors, advocates, facilitators of indigenous support systems, facilitators of indigenous healing systems, consultants, and change agents for their clients. As was noted in this case study, the school counselor followed many of the recommendations that Casas and Vasquez outlined in their general counseling framework in working with her young Filipino client. A brief summary of these steps is provided as follows.

I t is important to note that the counselor initially took time to ac- knowledge that she lacked an adequate knowledge base of the Fili- pino culture in general and of Filipino spiritual beliefs and traditions as they related to the grieving process in particular. Recogniz- ing that her lack of knowledge in these areas could lead her to mis- interpret the student’s grief reactions, she immediately contacted a Roman Catholic priest in the Filipino community to discuss the student’s situation. To develop a more extensive understanding of these issues, the school counselor subsequently took time to review the multicultural counseling literature in this area and conducted interviews with persons who were identified as experts in the Fili-


pino culture. These efforts greatly increased the school counselor’s understanding of the ways in which her young client’s behaviors reflected many of the spiritual beliefs that are rooted in Filipino culture. The new knowledge that she gained from researching the spiritual beliefs of people from Filipino ancestry had numerous implications for the way she conceptualized her client’s problem. Because the steps the first author took in dealing with her young Filipino client have rel- evance for the work other counselors do when providing mental health services among people from culturally diverse populations, a number of recommendations are presented and briefly discussed as follows. First, counselors are urged to avoid pathologizing behaviors that

are considered to be “inappropriate” and even “bizarre” among many people in the dominant cultural group in the United States without first considering the appropriateness of such behaviors from the client’s cultural context. D’Andrea ( 1998) recently explained that cultural differences (a) typically lead individuals to construct very different meanings about the problems they experience in their lives, and (b) greatly influence how individuals think they should react to these problems. For this reason, counselors have been encouraged to use constructivistic counseling approaches when working with culturally diverse clients. As numerous theorists have explained, constructivistic counseling approaches are based on the realization that individuals can and do construct very different meanings about their life experiences. This is especially the case when individuals come from very different backgrounds (D’Andrea, 1998; Sexton & Griffin, 1997).

I t has been further suggested that by using constructivistic approaches in multicultural counseling situations, counselors are better positioned to gain a more accurate and empathic understanding of the unique ways in which people from diverse cultural populations have learned to cope with life’s challenges (D’Andrea, 1998; Sexton & Griffin, 1997). Because many clients rely on spiritual beliefs and traditions that are embedded in their cultural background to cope with personal problems, it is very important that counselors understand how the construction of these spiritual beliefs are linked to the way people react to problems they encounter in their lives. By taking time to consider the ways in which the grieving Filipino student’s spiritual beliefs influenced his efforts to cope with the death of his mother, the school counselor avoided jumping to the conclusion that Mark’s behaviors were pathological in nature. Counselors are encouraged to refer to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-N; American Psychiatric Association, 1994) and the recent work of Ivey and Ivey (1 998) because both of


these resources provide a wealth of information that is helpful in identwng the caveats of diagnosing culturally based behaviors, beliefs, and traditions as pathology, Second, by increasing her knowledge about the spiritual beliefs and

traditions that people in the Filipino culture commonly display when grieving the loss of a loved one, the practitioner was forced to con- front some of her own ethnocentric views about death and the afterlife. It has been reported that many western counseling practitioners do not believe in the existence of spirits, angels, and ghosts (Kelly, 1995). Thus, when presented with clients who do have a strong belief in the existence of such supernatural forces, counselors may feel unsure as to how they should proceed in the counseling process. In the case of the grieving Filipino student, the school counselor

may have had a couple of choices regarding how she might proceed in working with this youngster. On the one hand, she could have used traditional western psychological theories in interpreting Marks behavior. In doing so, the counselor would have likely concluded that this student was suffering from pathological reactions to his mother’s death. By arriving at this type of conclusion, the youngster would probably have been referred for more intensive and ongoing psychotherapeutic services that would have included prescription medication to help ameliorate his reported hallucinations of his mother’s spirit and assist him in readjusting to school. However, rather than proceeding in this manner, the counselor chose to oper- ate from the perspective that there are multiple ways that clients may react to the death of a loved one and that these reactions are often influenced by the cultural-spiritual beliefs to which the clients adhere. By accepting the legitimacy of what many multiculturalists and postmodernists refer to as “multiple perspectives of reality” (D’Andrea. 1998; Gergen, 1994). counselors are able to understand the importance of (a) validating clients’ perspectives by providing supportive counseling services to persons from culturally different backgrounds (like Mark), because these clients seek to learn more constructive ways of dealing with the loss of loved ones; and (b) working as client advocates in helping promote positive changes in the systems in which their clients are a part. Because she accepted the legitimacy of the spiritual beliefs and traditions that are associated with the Filipino culture, the school counselor took time to consult with the teachers and the administrators at Mark’s school to (a) help them understand some of the culturally based beliefs about spirituality that contributed to the way Mark was responding to his mother’s death, and (b) discuss ways in which the teachers could help support him through the grieving process.

Journal ofMulticultural Counseling and Development / October 1999 / Vol. 27 / 221-239 235

From Marks perspective, experiencing his mother’s spirit was within his cultural group’s norms. However, these experiences resulted in academic problems from his failing to pay attention to the teacher in class and from his failing to complete classroom assignments. These school-related problems indicated that Mark needed assis- tance to resolve his loss and strengthen his support system. A s a result of the first author’s providing ongoing supportive counseling and client advocacy services, consulting with his teachers and school administrators, and collaborating with this client’s father and grandmother, Mark exhibited positive changes over time. These changes were improvement in his overall school performance, a reduction in the number of times he experienced the presence of his mother’s spirit while he was at school, a reduced level of depression that was associated with the loss of his mother, and increased positive interactions with his peers (Shimabukuro, 1995). In conclusion, this article reports on the challenges a school coun-

selor faced when presented with the case of a grieving Filipino student who was having difficulty coping with the death of his mother. By learning about the ways in which people from Filipino ancestry commonly use spiritual beliefs and traditions to cope with the death of loved ones, the school counselor was able to avoid pathologizing this client’s behavior and provide counseling, advocacy, and consultation services that reflected greater sensitivity and respect for the influence of his cultural background and spiritual beliefs. I t is hoped that this article increases other counselors’ awareness of some of the ways in which clients’ spiritual beliefs may come into play in counseling situations in general and enhance counselors’ understanding of the role Filipino spiritual beliefs and traditions play among persons from this cultural group in particular.

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