Even with the recent growth and focus on diversity, you may find your counselor is not thoroughly educated in providing services to a multicultural clientele. This can result in the counselor failing to consider important factors associated with your case. Ignoring the impact of social class and culture-related values can be significant barriers to multicultural counseling and may affect treatment, says psychologist Derald Wing Sue in his book, "Counseling the Culturally Diverse: Theory and Practice." Your counselor may also find it difficult to focus on characteristics associated with your values or culture instead of his or her own.

A language barrier between you and your counselor can also influence the effectiveness of therapy. Issues with spoken language are sometimes the biggest challenge for multicultural counseling and can result in extreme misunderstandings between you and your therapist, according to an article published by the American Counseling Association entitled “Cross-Cultural Counseling: How to Be More Effective.” Body language can also have different meanings depending on your culture. If your counselor does not understand a break of eye contact or automatically attributes other body language to assumptions based on culture, you could wind up feeling uncomfortable or misunderstood.

Counseling is a practice that originated primarily in western cultures. Therefore, it is largely based on concepts such as individualism, logic and competition, which are in opposition to the ideas associated with other cultures, according to psychiatrist Heesoon Jun in the book "Social Justice, Multicultural Counseling, and Practice." If you are from a culture that emphasizes family contributions to your identity and therapy, for example, it may come as a surprise to your counselor if you request the presence of family members during a session.

Bias can also be a major issue in multicultural counseling. To be effective, counselors must both understand bias in general and be able to refrain from engaging in stereotyping and prejudice in their practice, says Heesoon. Considering each client as an individual is essential, because even if two clients are from the same cultural background, they will have unique factors that will inform the session. Not discussing cultural factors at all, and minimizing the impact of differences, can be detrimental and can convey disrespect, even resulting in an inaccurate diagnosis or ineffective treatment.