The Application Of Hay’s Addressing Model In Culturally Competent Counseling


In the given case study, Hannah, a school counselor, a 36-year-old African-American woman, works with the 15-year-old Muslim-American school student, Adara. Being from a Muslim family and following the religious and cultural traditions, she has to wear a headscarf, which distinguishes her from her fellow schoolmates. She feels depressed and considers of killing herself after being bullied by other school children and people from the social media. Hannah tries to help the school student, but fails to do so by revealing everything to her parents. In this work, there will be analysis of what kind of mistakes were made by the psychologist during the therapy and what can be made to prevent such occasions while working in a culturally diverse environment. Finally, this paper will come up with the necessary cultural competencies that every psychologist should possess.


When working with clients from varied cultural backgrounds, the Addressing Model developed by Hay can be of great help to counselors. The importance of cultural sensitivity in understanding the patient and remaining objective when providing advice is emphasized through the case study. Adara, a 15-year-old Muslim-American high school student, struggles to fit in due to the hurdles posed by her environment and cultural norms that differ from those of the present society. These sentiments are consistent with the social identity theory and Erikson’s theory of psychological development. Social identity theory posits that individuals’ social systems and groups significantly impact their thoughts, actions, and perceptions about the world around them. According to this theory, the group the individual belongs to means more to other people than the individual characteristics of that person. In other words, people tend to categorize others in terms of their membership in a certain group rather than as separate individuals. In Adara’s case, other people at the school view her as a member of a different group, Muslims, stigmatizing her personality based on the group she belongs to. Her schoolmates consider their in-group superior to hers, consequently discriminating and separating Adara.

Secondly, Erikson’s theory of psychosocial development can also shed light on Adara’s perspective. Erikson argues that environmental pressures make people engage in dysfunctional thinking and behavior. They will persist if the surrounding environment supports or encourages these issues. In light of Adara’s environment’s lack of support, she begins to consider suicide.

The case study demonstrates the perfect example of how the lack of understanding of the culture-related background of a client or a patient can lead to the unsophisticated results of the therapy. In the relations between Adara and Hannah, the school counselor’s lack of understanding of cultural differences between people involved in a conflict leads to inadequate help to the student. It may even result in detrimental consequences.

Cultural Issue

Concerns about culture affect how members of that community interact with one another. According to the case study, Adara is coping with several psychological issues, any of which, if left untreated for an extended period, could eventually lead to her taking her own life. Adara experiences feelings of alienation regularly since she is a Muslim but lives in a country that does not practice Islam. Her parents make her wear a headscarf, an act that gives her the idea that she is treated differently from other children of her age. Her negative thoughts were compounded by the fact that she and her family had once lived in Dearborn, a suburb of Detroit, before moving to Riverbend. Her classmates’ misconceptions about Islam affect her mental health because of how they think about it. Because of her religious convictions, she is subjected to online harassment and is referred to as a “terrorist.” This constitutes a violation of her right to freedom of worship.

Hannah has suggested Adara discuss her issues with her parents and begin to see a therapist. On the other hand, Adara is adamant that her parents will not back her in her endeavor or agree with this decision. Given the cultural notion of mental health issues as a social stigma among Muslims, her parents would disapprove of her receiving treatment for a mental illness. Many Muslims believe that more fundamental concerns, such as the availability of food and prayer spaces, are more important than mental health difficulties. They are consequently less likely to trust or acknowledge the assistance of mental health professionals (Hays, 2020). In addition, according to Islamic teachings, a person with mental health concerns might receive guidance and comfort via prayer and the reading of Allah’s word. Adara comes from a household that adheres to Islamic principles and traditions. Due to the obstacles above, it is difficult for her to attract her parents’ attention.

Theoretical Explanations

Erikson’s theory of psychosocial development allows a person to discover their identity through eight unique stages of psychosocial development. Each stage occurs at a distinct period in a person’s life, and a psychological crisis follows each subsequent stage that the individual should overcome to go to the next stage (Maree, 2021). The conclusion of these crises can positively or negatively impact the development of an individual’s personality and identity, depending on how they are managed. Identity versus Role Confusion is the fifth stage of development, which occurs between the ages of 12 and 18 (Maree, 2021). The extensive inquiry at this stage of development into the values, concepts, and ambitions they identify is a critical component of an adolescent’s journey to discover their identity and sense of self. If a teen does not complete this stage successfully, they can encounter an identity crisis, which can significantly impact the adolescent’s ongoing psychological development. Adara, for example, has experienced social marginalization, bullying, a lack of family support, and a lack of parental participation as a Muslim-American female high school student.

In addition, social identity theory, introduced in the research by Henry Tajfel, helps explain Adara’s current situation, which has led her to develop suicidal thoughts. According to this theory, the social world is divided into two distinct groups: the in-group, which includes the social group with which an individual identifies, and the outgroup, which consists of all other social groupings (Harwood, 2020). The individuals’ social group identification can be significantly influenced by various factors, including culture, religion, age, sex, race, and socioeconomic standing. Therefore, Adara’s social identity is the group in which she asserts membership and gives her a sense of purpose and belonging in the world. One definition of a person’s social identity is the group to which they claim membership. They focus on boosting their sense of self-worth by using the identities they hold within their social groups (Harwood, 2020). In the case of Adara, due to the stigma associated with their religious beliefs, and racial and cultural background, members of other social groups can be hostile towards Adara as she belongs to the outgroup, which is inferior according to her schoolmates.

Professional Behaviors

Being from different backgrounds, culturally, ethnically, and religiously, Hannah as a school counselor, failed to give adequate help to her patient, Adara. Not taking into account the religious origin of Adara’s family and their attitude towards mental health issues, Hannah believed that by discussing the matter with Adara’s parents, she would solve the problem. By revealing all the confidential information, Hannah just ruined Adara’s trust in her and negatively affected the result of their therapy. As a professional psychologist, Hannah ignored the particular circumstances from which Adara originally came from, i.e. her religion and ethnicity. She should have maintained cultural awareness while giving Adara culturally relevant, situation-specific counseling and refraining from talking about her personal experiences. By deepening her understanding of Muslim concepts and beliefs, Hannah can improve her ability to counsel Adara. This case study demonstrates how detrimental the outcomes of the therapy can be if the cultural background of the patient was not taken into account. If Hannah continues to like this in such a culturally diverse environment, it can lead to more and more unresolved problems.

Research Findings

Two research studies with similar cases like Adara’s represent the cultural-related issues that Muslim-American students have to encounter. In the first study, Balkaya et al. (2019) surveyed Muslim-American adolescents between the ages of 13 and 18 about their perspectives on individual-level religious prejudice as part of a study that analyzed the participants’ internal and external behavior. During individual interviews, adolescents were asked to rate their contacts with religious discrimination on a scale from one to five, with one being never and five always (Balkaya et al., 2019). The prejudice the individuals encountered did not affect their religious identification but their American identity, which was linked to internal and external behavioral difficulties. Balkaya et al. (2019) concluded that Islamophobia was more significant in the discriminatory conduct reported by adolescents than religion alone in mediating instances of discrimination or influencing internal or external behaviors. This research study demonstrates similarity with Adara’s case as being between the age of 13 to 18; she also has to go through online discrimination and social rejection from her schoolmates. Similar to Balkaya et al.’s (2019) research findings, Adara suffers from internal and external problems because of her ‘unsuitable’ religious and ethnic background.

Concerning the utilization of mental health services in higher education, the second study was done to identify the widespread issues and concerns that Muslim college and university students believe should be addressed. The findings of the research conducted by Lowe et al. (2019), which concluded with intriguing and diverse material, revealed that Muslim college students perceive mental health problems as the least significant concern and that safety, food, and prayer facility concerns are rated as having greater significance. The participants stated extra concerns about entering college, including issues about religious practices and a heightened focus on social issues such as prejudice and discrimination. Examining the findings from the study by Lowe et al. (2019) alongside Hannah’s and Adara’s circumstances, it becomes evident why Adara’s parents do not urge and encourage their daughter to seek treatment for her mental-related problem. Moreover, both research findings demonstrated that a greater understanding and awareness of the needs of Muslim American children might increase the likelihood of successful integration and reduce instances of prejudices towards them.

Proposed Cultural Guidelines and Competencies

An inalienable part of every mental health professional’s work is understanding their patients’ principles and backgrounds. While working in a culturally diverse environment like that in the United States, a psychologist needs to possess a set of competencies such as the lack of bias, cultural knowledge, open attitude, and self-awareness to treat a patient with a therapy that is suitable for the particular case. For a psychologist to be competent while working with people from backgrounds different from theirs, it is important to consider some aspects such as race, ethnicity, culture, sex, age, socioeconomic status, and orientation. In the case of Adara, a school counselor should have had a greater understanding of Islamic beliefs and the numerous challenges Muslim-American students face in society. Hannah should have been more aware of the difficulties that the students like Adara might encounter. Instead of revealing everything to her parents, she should have suggested the therapy that would help in Adara’s case.


This conclusion is founded on the covered case study, and the research carried out afterward. As a professional psychologist, the psychological principles that I might adhere to are our cultural unbiasedness, cultural knowledge, skills, and open-mindedness. I believe that for the professional, it is important to respect the patient’s background, paying attention to their culture, ethnicity, race, age, sex, and orientation. As a psychologist, I will be able to improve my cultural competency by acknowledging different cultures and their principles, which will ultimately result in more beneficial therapy sessions with my patients. If I make it a point to consistently advocate for my patient’s well-being and maintain open lines of communication with them, I will be able to preserve my patients’ success and develop a friendly environment.


Balkaya, M., Cheah, C. S., & Tahseen, M. (2019). The mediating role of multiple group identities in the relations between religious discrimination and Muslim‐American adolescents’ adjustment. Journal of Social Issues, 75(2), 538-567.

Harwood, J. (2020). Social identity theory. In J. V. Bulck (Ed.), The international encyclopedia of media psychology. John Wiley & Sons.

Hays, D. G. (2020). Multicultural and social justice counseling competency research: Opportunities for innovation. Journal of Counseling & Development, 98(3), 331-344.

Lowe, S. R., Tineo, P., & Young, M. N. (2019). Perceived discrimination and major depression and generalized anxiety symptoms: In Muslim American college students. Journal of Religion and Health, 58(4), 1136-1145.

Maree, J. G. (2021). The psychosocial development theory of Erik Erikson: a critical overview. Early Child Development and Care, 191(7-8), 1107-1121.