The role of culture and cultural techniques in psychotherapy: A critique and reformulation (original) (raw)
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Ten considerations in addressing cultural differences in psychotherapy
Professional Psychology: Research and Practice, 2003
As the United States population grows more culturally diverse, it is increasingly likely that psychologists will treat patients from dissimilar cultural backgrounds. Psychologists are often undecided about whether it is therapeutically appropriate to address cultural differences. Ten clinical considerations regarding the appropriateness of discussing cultural differences with patients are described. Examples are provided of how these suggested guidelines may apply to clinical practice. The literature that has supported addressing differences, including selected theoretical models, is cited in the context of these recommendations. All psychotherapy cases are distinct; therefore, these general guidelines should be adapted to the requirements of the individual patient. Theoretical Perspectives Cultural differences have been understood through three distinct perspectives: universalism, particularism, and transcendism (Se-MARTIN J. LA ROCHE received his PhD in clinical psychology from the University of Massachusetts at Boston. He is currently an instructor in the Department of Psychiatry at Harvard Medical School at the Children's Hospital Boston/Martha Eliot Health Center and is in independent practice in the Cambridge, MA, area. His current areas of research are multicultural psychotherapy and health psychology. APRILE MAXIE received her PhD in clinical psychology from the University of Massachusetts at Amherst. She is a postdoctoral fellow in the Department of Psychiatry at Kaiser Permanente in Oakland, CA. Her current area of research is cross-cultural psychotherapy and treatment-seeking in ethnic minority populations.
Culturally competent psychotherapy
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2003
To provide effective psychotherapy for culturally different patients, therapists need to attain cultural competence, which can be divided broadly into the 2 intersecting dimensions of generic and specific cultural competencies. Generic cultural competence includes the knowledge and skill set necessary to work effectively in any cross-cultural therapeutic encounter. For each phase of psychotherapy--preengagement, engagement, assessment and feedback, treatment, and termination--we discuss clinically relevant generic cultural issues under the following headings: therapist, patient, family or group, and technique. Specific cultural competence enables therapists to work effectively with a specific ethnocultural community and also affects each phase of psychotherapy. A comprehensive assessment and treatment approach is required to consider the specific effects of culture on the patient. Cultural analysis (CA) elaborates the DSM-IV cultural formulation, tailoring it for psychotherapy; it i...
The Case for Cultural Competency in Psychotherapeutic Interventions
Annual Review of Psychology, 2009
Cultural competency practices have been widely adopted in the mental health field because of the disparities in the quality of services delivered to ethnic minority groups. In this review, we examine the meaning of cultural competency, positions that have been taken in favor of and against it, and the guidelines for its practice in the mental health field. Empirical research that tests the benefits of cultural competency is discussed.
Psychotherapy research with ethnic minorities: Empirical, ethical, and conceptual issues
Journal of Consulting and Clinical Psychology, 2001
There is an increasing demand for psychotherapy among ethnic minority populations. Yet, there is not adequate evidence that empirically supported therapies (ESTs) are effective with ethnic minorities. Ethical guidelines suggest that psychotherapies be modified to become culturally appropriate for ethnic minority persons. Conceptual approaches have identified interdependence, spirituality, and discrimination as considerations for culturally sensitive therapy (CST). However, there is no more empirical support for the efficacy of CSTs than there is for the efficacy of ESTs with ethnic minority populations. The chasm between EST and CST research is a function of differences between methods and researchers in these 2 traditions. Specific recommendations for research collaboration between CST and EST researchers are offered. There is a need for psychotherapies for ethnic minority populations that are both empirically supported and culturally sensitive. One impetus for this demand is scientific. Inclusion of ethnic minority populations may help determine the external validity of psychotherapy research (Hohmann & Parron, 1996 ; S. Sue, 1999). Psychotherapy efficacy should be investigated with ethnic minority groups to determine the generalizability of psychotherapy approaches (cf. Okazaki & Sue, 1995). For these reasons, the National Institutes of Health (NIH) in 1994 created a policy that requires the inclusion of ethnic minority persons in federally funded research (Hohmann & Parron, 1996). Although there is increasing empirical support for several psychotherapies for certain disorders, there is not adequate empirical evidence that any of these empirically supported therapies (ESTs) is effective with ethnic minority populations (
The theory, process, and outcomes of culturally adapted psychotherapy and psychosocial interventions
2018
Rowe whose example and towering legacy was equal parts challenge and inspiration; and Dr. Francesca Parker whose excellent questions and support helped push the process further and faster. I owe a debt of gratitude to the entire Psychology faculty of Pepperdine University's Graduate School of Education and Psychology; the deep bench of excellent scholars in multicultural psychology is an unmatched treasure. I wish to thank my parents, who provided the foundation and whose influence can clearly be seen in this intersection of clinical and critical inquiry. I am grateful for the legacy received from my ancestors: a group of rebels, thieves, artists, justice seekers, gadflies, and healers whose example I do my best to follow. I'm grateful for my treasured readers and thought leaders: Amy Bloom, Sarah Moon, and Rachel Weller. Finally, none of this would have been possible (or even attempted) were it not for Corey Sorenson.
Annual Review of Clinical Psychology, 2014
Despite compelling arguments for the dissemination of evidence-based treatments (EBTs), questions regarding their relevance to ethnically diverse populations remain. This review summarizes what is known about psychotherapy effects with ethnic minorities, with a particular focus on the role of cultural competence when implementing EBTs. Specifically, we address three questions: (a) does psychotherapy work with ethnic minorities, (b) do psychotherapy effects differ by ethnicity, and (c) does cultural tailoring enhance treatment effects? The evidence suggests that psychotherapy is generally effective with ethnic minorities, and treatment effects are fairly robust across cultural groups and problem areas. However, evidence for cultural competence is mixed. Ethnic minority-focused treatments frequently incorporate culturally tailored strategies, and these tailored treatments are mostly efficacious; yet support for cultural competence as a useful supplement to standard treatment remains equivocal at best. We also discuss research limitations, areas for future research, and clinical implications.
Cultural control in psychotherapy with minority clients
Psychotherapy: Theory, Research & Practice, 1983
The published literature on mental health services for minority clients suggests that these persons experience special problems with the traditional mental health delivery system. Epidemiological and attitude studies have indicated that minority client and majority therapist expectations for psychotherapy are often discrepant. Counseling and psychotherapy outcome research on therapist-client racial pairing has yielded inconclusive results at present. It is hypothesized that therapist-client racial pairing may interact with level of therapist dominance in affecting psychotherapy outcome. Dominant majority clinicians may manipulate minority persons toward majority values, which may comprise a form of cultural control. Highly dominant clinicians are posited to function more effectively with culturally-similar clients than with culturally-different clients in that domination may be appropriate to a certain degree in culturally homogeneous settings. Low dominant clinicians are posited as being more effective than highly dominant clinicians with culturally different clients in that they would be more likely to attempt to understand the client's cultural perspective in a non-manipulative manner. A major component of the Zeitgeist of the community mental health movement has been the delivery of services to minority groups in society. Mental health facilities have been
Cultural competence and psychotherapy: Applying anthropologically informed conceptions of culture
Psychotherapy: Theory, Research, Practice, Training, 2006
The authors apply two contemporary notions of culture to advance the conceptual basis of cultural competence in psychotherapy: Kleinman's (1995) definition of culture as what is at stake in local, social worlds, and Mattingly and Lawlor's (2001) concept of shared narratives between practitioners and patients. The authors examine these cultural constructs within a clinical case of an immigrant family caring for a young boy with an autism-spectrum disorder. Their analysis suggests that the socially based model of culture and the concept of shared narratives have the potential to broaden and enrich the definition of cultural competence beyond its current emphasis on the presumed cultural differences of specific racial and ethnic minority groups.