In 1994 she founded RED NOSES in Austria, developing during 30 years a professional Healthcare Clown Program and escalating it internationally to 11 more countries and worldwide Emergency Missions.

[6] In 1974, she worked at the Institut Europeen d'Administration des Affairs (INSEAD) at Fontainebleau in France as a public relations assistant throughout the academic year of 1974–75.

[7] In 1976, Culen was hired as the public relations and protocol officer at the newly established OPEC Fund for International Development.

In 1991, Culen co-founded one of the first European hospital clowning projects, Cliniclowns Österreich, and helped develop the strategic concepts and guidelines for such organizations in Austria, Netherlands and Belgium.

Since 1996, RED NOSES opened partner organisations in Germany, Hungary, Slovakia, Slovenia, Czech Republic, Croatia, Poland, Lithuania as well as branch offices in Jordan and Palestine.

[10] Furthermore, RED NOSES Clowndoctors International undertakes humanitarian missions through the Emergency Smile programme in crisis areas, refugee camps and other institutions worldwide.