In today’s multicultural world, many counselors and therapists seek to learn more about how to understand and serve clients who have culturally diverse backgrounds.  Unfortunately, the literature on multicultural counseling is often filled with empty clichés like “embracing diversity” and “building bridges.”  Therapists are urged to become aware of their own communication style and consider the client’s perspective, as if they weren’t already doing those things.

Some experts focus on a single cultural or ethnic group and offer concrete advice within a particular cultural framework.  In one primer, for example, therapists who work with Arab American clients are advised to dress well, be hospitable, repeat responses, and sit so the soles of their shoes don’t face toward the client (which is an insult in the Arab world).  This kind of advice is helpful, of course, but it doesn’t give therapists the specific tools they need to genuinely help their clients.

Noticeably missing in the literature is an evidence-based discussion of specific techniques that are likely to work or not work for various cultural groups.  Imagine, for example, if researchers learned that flooding (a treatment for phobias) is effective for some cultural groups but not others.  That kind of information would be extremely valuable to therapists, counselors, and other mental health professionals.

Perhaps help is on the way.  In a study published last year in the Journal of Cross-Cultural Psychology, Kristin Layous and her colleagues compared the effectiveness of two different happiness-increasing activities—expressing gratitude and performing kind acts—in the United States and South Korea.

College students in each country were randomly assigned to one of three groups.  In the first group, participants expressed gratitude by writing a letter to a person for whom they were grateful.  They wrote one letter a week for 3 weeks in a row.  In the second group, participants performed three acts of kindness each week for 3 weeks.  In the third group—a control condition—participants listed what they did in the past 24 hours, once a week for 3 weeks running.

Before, during, and after the study, participants reported (1) how satisfied they were with their life and (2) their current mood.  The researchers discovered that one of the activities—performing kind acts—increased happiness for Americans and South Koreans alike, but the other activity—expressing gratitude—didn’t work equally well for both groups.  The South Koreans benefitted significantly less from writing the gratitude letter than Americans did.

Layous and her colleagues argue that expressing gratitude is a double-edged sword for persons who live in a collectivist society.  Yes, writing a letter of gratitude probably makes one feel valued and connected to others, but it may also induce feelings of indebtedness and guilt.  A son, for example, may realize how much his parents have sacrificed for him and be reminded of his own (unfulfilled) duty to care for his parents.  The extended family in a collectivist society is like a mutual-aid society with its intricate web of benefits and obligations.  Much is given, but much is expected.

The findings of Layous’s study suggest that some therapeutic activities may be universally effective, but others might work only in particular locations and settings.  In today’s multicultural world, we need more studies that investigate “culture-activity fit.”

The degree of fit will be determined in large part by cultural values and beliefs.  An emotionally distraught !Kung bushman in the Kalahari Desert may benefit from a magic amulet or spirit-cleansing ceremony but is unlikely to accept a healer’s assertion that his psychological problems were caused by an unresolved Oedipal complex.


Layous, K., Lee, H., Choi, I., & Lyubomirsky, S. (2013). Culture matters when designing a successful happiness-increasing activity: A comparison of the United States and South Korea. Journal of Cross-Cultural Psychology, 44(8), 1294-1303.

Nobles, A., & Sciarra, D. (2000). Cultural determinants in the treatment of Arab Americans: A primer for mainstream therapists. American Journal of Orthopsychiatry, 70(2), 182-191.

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