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Introduction
During the past 20 years, multiculturalism has become recognized as a powerful force in all clinically based disciplines, not just for understanding various ethnic groups who might be clients, but also for training culturally competent practitioners such as psychiatrists, nurses, counselors, social workers, and psychologists, who would be able to provide effective healthcare services. In cross-cultural mental health research, attention is directed to constantly reviewing issues on cultural meanings and health beliefs and repeatedly examining the integration of cultural competency in clinical training and practice. In fact, those are two important but fundamental areas mental health professionals need to explore and understand in order to improve proficiency to better serve all potential clients.
Research on cultural meanings
In most cases, language is the primary means of communicating cultural beliefs, values and norms. Language also expresses the cultural heritage of an individual and is a source of identity and pride ([5] Carnevale et al. , 2009; [21] Santiago-Rivera and Altarriba, 2002). As [13] Mishne (2002, p. 64) observed, "communication in a professional conversation must convey tact, careful, attentive listening, empathy, and recognition of both the conscious and unconscious aspects of human motivation". Besides, verbal communication, cultural nonverbal behaviors such as social distance, spacing, touching, facial expression, and gesturing as well as vocal cues such as tone, rate, and intonation should be observed. People from some cultures make more use of nonverbal or indirect communication than verbal communication. Accordingly, establishing and maintaining a professional therapeutic relationship is dependent upon the practitioner's ability to effectively communicate with the client ([24] Spruill et al. , 2004).
In healthcare settings, competent communication with service-users is a primary and basic foundation for providing quality care and trust building ([5] Carnevale et al. , 2009). Poor communication may break the relationship or create tension in conversation. Thus, a lack of language competence exacerbates fear and anxiety, because emotions are shaped by the social or cultural context rather than solely by biological determinants. Emotion and culture are, therefore, closely intertwined and can be examined through language expression ([2] Altarriba, 2002). Researches revealed that the emotional tone and power of language vary greatly depending upon individual experiences, even among people who speak the same language ([15] Perez Foster, 1999; [16] Ramos-Sanchez, 2007)....