How a Therapist Responds to Cultural Versus Noncultural Dialogue in Cross-Cultural Clinical Practice

Abstract

A therapist's capacity to respond appropriately to a client is crucial in fostering positive therapeutic relationships and outcomes in general but it is even more important in cross-cultural therapy. Given the clinical significance of the dyad-specific and dynamic nature of the therapist's responsiveness, our study explores one white female therapist's responsiveness with three racial/ethnic minority clients in the beginning phase of therapy sessions. Using the structural analysis of social behavior and conversation analysis, the turn-by-turn intensive analysis of culturally relevant and nonrelevant talk in therapy illustrates how a therapist, who is appropriately and positively responsive to clients in other contexts, becomes disengaged and even negatively oriented during culturally relevant talk. This finding illustrates the challenges involved in maintaining positive engagement and responsiveness in cross-cultural therapeutic communication. Our findings also highlight the usefulness of focusing on moment-to-moment interactions in cross-cultural clinical practice.

Keywords::

• therapist's responsiveness
• cultural responsiveness
• cultural dialogue
• psychotherapy process research
• clinical social work practice

Acknowledgments

The first author wishes to acknowledge the Fahs-Beck New York Trust Fund Experimental Research Dissertation Grant and the Smith College Roger Miller Dissertation Grant for research funding support. She also greatly appreciates Drs Kathryn Basham and Joyce Everett for their helpful comments and support on the earlier work of this study.

Notes

^1. In all vignettes in this paper, C refers to the client, T refers to the therapist, and alphabetical numbers indicate speaking turns by the client or the therapist in each episode.

Additional information

Notes on contributors

Eunjung Lee

Eunjung Lee is an Assistant Professor at the Factor-Inwentash Faculty of Social Work, University of Toronto in Canada. She is a psychotherapy process researcher focusing on cross-cultural clinical practice. Her other research interests are immigration, transnationalism, and supervision and training. Address: Factor-Inwentash Faculty of Social Work, University of Toronto, Canada. [E-mail: [email protected]]

Adam Otto Horvath

Adam Otto Horvath, MSW, Ed.D. is a professor emeritus at Simon Fraser University in Canada and clinical professor at the Pontificia Universidad Católica de Chile. His research interests include: the relationship in psychotherapy, analysis of therapy dialogues and couples therapy dynamics. He is a past president of the North American chapter of the Society for Psychotherapy Research. Apart from teaching supervision and research he maintains an active clinical practice. Address: Faculty of Education and Department of Psychology, Simon Fraser University, Burnaby, Canada.