Counseling has had a long history of global expansion (Gerstein et al., 2009a), and, over the past decades, it has become a worldwide profession (Hodges, 2025). In its 2022 world mental health report, the World Health Organization acknowledged positive worldwide societal changes that have occurred over the past 20 years, including an increased understanding of mental health issues, the use of international frameworks for improving mental health, and the development of mental health guidelines and policies in many countries. However, the World Health Organization also discussed the high level of mental health concerns in all countries and the need for additional changes. One of their recommendations was to increase the number of culturally competent mental health workers who, ideally, “belong to the same community as the people served and adapt treatment to incorporate local cultural aspects and beliefs” (p. 133). Consequently, there is a strong need for counselors worldwide who are able and willing to engage in culturally competent care.

The provision of culturally competent care becomes more complex when considering the increasingly high migration across the world. Currently, approximately l in 30 people live in countries in which they were not born, and the number of immigrants living across all United Nations regions increased between 1990 and 2020, particularly in Asia and Europe (International Organization for Migration, 2024). In the United States, a record 51.4 million immigrants were living in the country as of February 2024, which accounts for 15.5% of the overall population (Camarota & Zeigler, 2024). As a result, counselors must be prepared to work in international settings (Gerstein & Ægisdóttir, 2007) and with international populations. The American Mental Health Counselors Association (AMHCA) has echoed this call for internationally competent counseling. For example, the AMHCA Code of Ethics (AMHCA, 2020) specifies the importance of all counselors being “competent with respect to cultural diversity” (C.1.g.) and “cognizant of cultural norms in relation to fee arrangements, bartering, and gifts” (E.2.). AMHCA is also a partner of the International Association for Counselling (IAC), a global advocate for the profession that has consultative status with the United Nations (IAC, 2016a).

Given the globalization of counseling and current migration trends, it is essential for practicing clinical mental health counselors to be aware of issues relevant to working in international settings and with foreign-born clients. Although there has historically been a lack of published articles on international counseling (Gerstein & Ægisdóttir, 2007), this has begun to change over the past 15 years. For example, the first Handbook of Cross-Cultural Counseling was published in 2009 (Gerstein et al., 2009b). Additionally, a study of articles published in the Journal of Counseling & Development reported that there has been a notable increase in internationally focused articles between 2000 and 2019 (Anderson et al., 2021).

The articles in this special issue of the Journal of Mental Health Counseling add to the available literature by highlighting practical ways in which counselors and counselors-in-training can become involved with culturally competent international counseling: providing services to international students and intercultural couples, working in international schools, and engaging in time-limited transcultural counseling. Two articles focus on working with international populations within one’s country of residence, and two provide information primarily for counselors interested in traveling to different countries. Together, they offer guidelines and recommendations devised to assist counselors when working in several areas of international counseling.

INTERNATIONAL STUDENTS AND INTERCULTURAL COUPLES

Internationally mobile students, typically called international students, are unique among foreign-born populations in that they come to a country for the sole purpose of receiving education, often returning to their home countries upon completion. The number of international students worldwide has tripled in the past 25 years from approximately 2 million in 1998 to 6.4 million in 2021. At slightly over 1 million, the United States currently hosts the most international students (United Nations Educational, Scientific and Cultural Organization, 2023, as cited in Migration Data Portal, 2024), representing 5.6% of tertiary students in the country (Open Doors, 2023). International students often experience a variety of mental health issues when adjusting to a new culture, such as acculturative stress. However, they also tend to underutilize counseling services (Mesidor & Sly, 2016). In their contribution to this special issue, Calder and Ho (2024) discuss ways in which counselors can provide culturally sensitive interventions to international students through the lens of transnational identity development. They provide holistic implications for counselors, which include assessment, acculturation support, and community collaborations. Additionally, they discuss how narrative therapy in particular can be helpful when working with international students.

A second internationally relevant population that is increasing across countries is intercultural couples (see Hiew et al., 2016), who consist of partners born and raised in different countries. Providing couple and family counseling is an important aspect of counseling in general, with a recent qualitative study on international counseling values finding this to be a prominent theme (Perron et al., 2023). Intercultural couples face unique challenges, such as differences in communication styles and cultural traditions (Machette & Cionea, 2023), that require culturally tailored interventions. In this special issue, Salvioni (2024) discusses important considerations when working with intercultural couples. Writing partly from a personal narrative perspective, Salvioni utilizes the expertise gained in counseling American women/Italian men couples in Florence, Italy. In addition to recommendations relevant for working with intercultural couples in general, Salvioni provides specific information about Italy and common issues that arise in relationships between American women and Italian men, ending with a detailed case example that includes concrete interventions.

INTERNATIONAL SCHOOLS AND TIME-LIMITED TRANSCULTURAL COUNSELING

Many counselors around the world can expect to work with foreign-born clients during their practice. However, there are also opportunities for counselors to do the reverse and work abroad with clients in a different country. For counselors interested in working with children and adolescents, one major way to do so is to become a counselor at an international school. International schools serve the children of those who relocate to different countries, primarily for employment. The children who attend these schools are typically considered third culture kids (TCKs), who build their own culture based on the cultures to which they have been exposed. Research has noted several mental health challenges for TCKs, primarily related to adjustment, loss and grief, and loneliness (Tan et al., 2021). There is consequently a need for culturally competent counselors to work with these children. The aforementioned qualitative study by Perron et al. (2023) found that counseling children, especially in school settings, is a prominent value of counselors worldwide, indicating its importance to the profession. In the third article of this special issue, Limberg et al. (2024) provide a practical discussion of how counselors can become involved with international schools. They include an overview of what international schools are, challenges experienced by TCKs, and the role of counselors in international schools. The article ends with a brief practical guide to the process of applying to work in these schools.

There are also shorter practice opportunities for counselors interested in engaging in counseling in other countries who do not want to move there. One important way to do so is through time-limited transcultural counseling. The definition of transcultural counseling is generally broad and can include any form of counseling that involves people of diverse identities (see Ibrahim, 1999). The IAC (2016b) provides a 20-hour continuing education course designed for counselors across the world covering this topic. In the final article in this special issue, Herod (2024) discusses a brief form of transcultural counseling that involves counselors, along with a team of other professionals, traveling to another country to provide specific, time-limited services, such as in the aftermath of a disaster. Based partly on the author’s own personal experiences, and infused with a variety of examples, Herod details the opportunities and challenges inherent in Western-based counselors engaging in brief transcultural counseling in non-Western countries. The article ends with an overview of practical considerations for counselors interested in time-limited transcultural counseling.

CONCLUSION

As both globalization and mental health needs increase, counseling is poised to become a cornerstone for mental health services around the world. The articles in this special issue highlight ways in which counselors can practically engage in culturally competent services with several internationally focused populations in both their countries of residence and other countries. It is my hope that counselors will continue to engage in and advocate for culturally competent care with international populations and be active agents for the future of mental health care for all.

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