Cross-cultural Therapy Research Articles

Characteristick Of Counselors In Cross-Cultural Counseling In The Society 5.0 Era

Cross-cultural counseling is very important when a counselor and counselee come from different backgrounds. As a result, a counselor must understand, be aware of, and show sensitivity to the values generally accepted in society. It is undoubtedly important for both parties to understand each other's culture in cross-cultural therapy. A counselor needs certain traits or qualities to carry out the duties of a counselor in extraordinary cross-cultural therapy. For this reason, it is very important for a counselor to be culturally sensitive, free from prejudice, aware of cultural diversity, and able to adapt to different cultural contexts. This writing was carried out to explain and provide an overview of the competencies, guidelines, challenges, problems and characteristics of counselors in cross-cultural counseling in the era of society which are really needed in the period of society 5.0. This writing uses a library research approach. Based on the writing of this article, it was found that the possibility of counseling success is directly proportional to the extent to which the counselor and counselee share the same perspective on this problem (both psychologically and socio-culturally), and vice versa. The client is understood not only in purely psychological terms, but also as an active part of the culture in addition to being understood in those terms. It is believed that the cultural landmarks clients experience shape their identity, along with their sentiments and experiences.

Ultra-Orthodox Parents' Perceptions of Arts Therapies for Their Children.

Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents’ sense of responsibility for their child’s religious education exacerbates these problems in child therapy. However, there is scant research on child therapy for the Ultra-Orthodox, especially in the field of arts therapies. The present study examined the perceptions of 17 Ultra-Orthodox parents whose children were receiving arts therapies (including art therapy, dance/movement therapy, music therapy, psychodrama and bibliotherapy). Semi-structured interviews were conducted with the parents and analyzed based on the principles of Consensual Qualitative Research. The study covered five domains: (1) The parents’ experiences in therapy; (2) The parents’ perceptions of the child’s experiences in therapy; (3) Implications of environmental-social factors on the parents’ perceptions and experiences of therapy; (4) Effects of intercultural aspects on therapy; (5) Perceptions of the use of the arts in therapy. The findings show that the experiences of ultra-Orthodox parents in the arts therapies of their children is complex due to the influence of the socio-cultural context, which involves dealing with stigma and tensions in their relationship with the education system. This context also shapes their perceptions of therapy, which can be characterized as purpose-oriented. The findings also highlight the parents’ challenges in coping with the intercultural therapeutic relationship, and emphasizes the parents’ preference for a therapist from a similar religious/cultural background and for cultural supervision of therapy. However, the results also suggest that there are benefits inherent to intercultural therapy in general and arts therapies in particular, including a sense of security, openness and acceptance of the parents and children.

Microskills of broaching and bridging in cross-cultural psychotherapy: Locating therapy skills in the epistemic domain toward fostering epistemic justice.

Psychotherapy research has shown evidence of positive impacts of broaching cultural differences on the therapy process and outcomes. This increasing body of research also highlights a need to clarify clinical skills of broaching and subsequent bridging to guide therapists in cross-cultural psychotherapy. In articulating microskills to promote broaching and bridging, we critically reflect on cautions against slipping into a technocratic approach that is a mechanical prescriptive skill-based guideline. Using critical theory on epistemic injustice, we examine how to integrate cultural aspects into therapy conversations that are aligned with epistemic and social justice. Drawing from sociolinguistic and critical scholars on language and power, we interrogate epistemic domains of knowledge and power during broaching and bridging in everyday clinical talks. We focus on theorizing and illustrating "how-to-do" broaching and bridging to guide therapists in everyday cross-cultural encounters with selected microskills such as a therapist's self-disclosure, cultural immediacy, and reflective listening. Using case illustrations with detailed transcripts for each skill, we interrogate how a client's epistemic status can be managed in the moment-to-moment conversation between a client and therapist in the continuum from dismissing to deepening the client's experience. A series of detailed case illustrations are intended to guide therapists' self-reflection and/or train therapists toward meaningful cross-cultural work. Lastly, we discuss the implications of broaching and bridging while situating this work as promoting epistemic justice in cross-cultural therapy encounters. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Non-Haredi Arts Therapists' Perceptions of Therapy With Ultra-Orthodox Children.

Studies have underscored the complexity of the encounter between ultra-Orthodox (Haredi) society and psychotherapy, as well as the challenges involved in developing a therapeutic relationship in cross-cultural therapy. However, there is scant research on therapy for ultra-Orthodox children, especially when it comes to arts therapies that take place in a cross-cultural setting. The current study examined the perceptions of 17 arts therapists (including visual art therapists, dance/movement therapists, psychodramatists, music therapists and bibliotherapists) who are not ultra-Orthodox, and who currently work or have previously worked with ultra-Orthodox children. Semi-structured interviews were conducted with the therapists and analyzed using the principles of Consensual Qualitative Research. The study covered four domains: (1) perceptions of the significance and objectives of arts therapy with ultra-Orthodox children; (2) the influence of the cultural difference between therapist and client on the emotional experience and the therapeutic relationship; (3) the use of arts in therapy; (4) systemic aspects. The findings indicate significant perceptual and value-based disparities between therapists and clients, which pose difficulties and challenges to all participating parties and require therapists to be highly sensitive. Aside from the difficulties, the findings suggest that this cultural difference may also have certain advantages for clients as well as therapists. The findings likewise attest to the multifaceted process of change that is taking place within Haredi society in its attitude toward psychotherapy in general and arts therapy in particular.

Experiences of psychotherapists working with refugees in Germany: a qualitative study

BackgroundDespite a high burden of mental health problems among refugees, there is limited knowledge about effective mental health care provision for this group. Although substantial efforts in understanding the complexity of cross-cultural psychotherapy – which in the context of this study we use to refer to therapy with client and therapist of different cultural backgrounds – have been made, there remains a dearth of research exploring barriers for effective cross-cultural psychotherapy. This study aimed at narrowing this gap in knowledge by exploring major challenges encountered by psychotherapists in cross-cultural psychotherapy and strategies which have proven useful in overcoming such challenges.MethodsWe employed a qualitative study design, conducting semi-structured in-depth interviews with 10 purposely selected psychotherapists working with refugees in Germany. Respondents were from varying theoretical background and had varying levels of experience. Data were analyzed using a thematic approach, following a mix of deductive and inductive coding.ResultsRespondents reported three main challenges in their cross-cultural practice: different or unrealistic expectations of clients towards what psychotherapy would offer them; challenges grounded in different illness explanatory models; and communication challenges. In dealing with these challenges, respondents recommended psychoeducation to overcome issues related to problematic expectations towards psychotherapy; “imagining the real”, identifying “counter magic” and other client-appropriate resources to deal with issues related to clients’ foreign illness attributions; and translators in dealing with communication barriers, though the latter not univocally.ConclusionsResults show that psychotherapy with refugees can be very successful, at least from the psychotherapist perspective, but also poses significant challenges. Our findings underline the importance of developing, testing, and institutionalizing structured and structural approaches to training psychotherapists in cross-cultural therapy at scale, to accommodate the rising mental health care need of refugees as a client group.

The Dedyco device, a therapy of the mother-child bond through storytelling in a transcultural setting

The device Dedyco is a mixture of two practices clinical storytelling workshops and cross-cultural therapy consultation for families. Tales, graphic productions, staging games allow mothers and their children to share a moment out of time, in the footsteps of wonderful characters.

Social Action in Practice: Shifting the Ethnocentric Lens in Cross-Cultural Art Therapy Encounters

With the advance of globalization and changing demographics, an intercultural perspective that is self-reflexively aware of ethnocentric bias is increasingly important for art therapists. This article draws from cross-cultural art therapy in the international service realm to consider the nature of art therapy as a distinctly cultural practice. The professionalization of distress within the activist paradigm of care is examined and exemplified with two lenses viewing the same encounter, one monocultural and the other ethnorelative. Cultural frame switching and other conceptual tools to disrupt conditioned responses and to develop ethical praxis, multicultural competency, and intercultural sensitivity at home and abroad are presented.

Fragmented Images: How Can the Eye See Itself? A Relational and Intersubjective Reformulation of Cross-Cultural Therapy with Cecilia

This article discusses why it is crucial in the cross-cultural clinical encounter to practice from both Jessica Benjamin's intersubjective frame as well as relational theory when the therapist is from the dominant White culture and the client is African American. Intersubjective and relational theories are utilized to illustrate how it is in this clinical situation, however, that some therapists may find themselves avoiding the use of a more relational practice. A case illustration is presented from the lens of Winnicott's theory of object relations to convey the dynamic complexities that may impede a therapist from practicing out of these (more relational) frames and then the case is reconceptualized from both a relational and intersubjective perspective.

Strategies Used by Foreign-Born Family Therapists to Connect Across Cultural Differences: A Thematic Analysis.

With the growing diversity in the United States among both clinicians and clients, many therapeutic encounters are cross-cultural, requiring providers to connect across cultural differences. Foreign-born therapists have many areas of differences to work through. Thus, exploring how foreign-born family therapists in the United States connect to their clients can uncover helpful strategies that all therapists can use to establish stronger cross-cultural therapeutic connections. A thematic analysis was conducted to understand strategies 13 foreign-born therapists used during therapeutic encounters. Four themes were identified: making therapy a human-to-human connection, dealing with stereotypes, what really matters, and flexibility. Findings suggest that developing a deep therapeutic connection using emotional attunement and human-to-human engagement is crucial for successful cross-cultural therapy. Clinical and training implications are provided.

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

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.

The Process of Cross-Cultural Therapy between White Therapists and Clients of African-Caribbean Descent

This study explores clients' and therapists' experiences of cross-cultural psychological therapy with specific reference to issues of race and culture. Three British African-Caribbean psychotherapy clients and their white British therapists took part in one-to-one interviews. A thematic analysis was conducted on their interview transcripts; this drew on social constructionist principles to focus on patterns of meaning in the participants' accounts. Four themes are presented in this article. Each theme relates to the perceived impact of “visible racial difference” on the therapeutic process. The therapists described the demands of having to be vigilant about political incorrectness and balanced this against their positive identification with the client group. The clients described an unspoken rule (“no race talk in therapy”) and outlined their strategies for distancing their “racial” selves from the therapy in order to make sense of their therapeutic experiences. We argue that dominant cultural discourses minimise or prevent race and culture conversations from taking place in therapy. While the strategies used by participants seemed to enable them to maintain a positive therapeutic relationship and attend to the tasks of therapy, the absence of open discussion excluded fundamental aspects of the client's identity from the therapeutic milieu.

Engagement in Cross-Cultural Clinical Practice: Narrative Analysis of First Sessions

Based on a larger process-outcome study on cross-cultural clinical practice, this report focuses on the client-practitioner engagement process during the first session in cross-cultural therapy. Nine cases with complete pre- and post-treatment measures, process measures, and verbatim session transcripts were selected. The cases represent a wide variety of client-practitioner ethno-cultural differences. The outcome of these cases was determined by a combination of objective and subjective measures. Client-practitioner interaction processes were subject to complex coding and process analysis, following a narrative research strategy, to discover patterns associated with positive cross-cultural engagement. Results showed that positive engagement is associated with effectively communicated cognitive understanding of the client’s needs and concerns, emotional attunement, and appropriate handling of specific cultural experiences.

Couples on the Fault Line: New Directions for Therapists

This book provides an overview of relevant issues that many couples face today. Directed at clinicians who work with families and couples, this book strives to offer a fresh perspective on the various social and technological issues that affect couples in our society. It also intends to provide techniques with which to navigate such issues as they arise in therapy. With chapter contributions from numerous authors, specific and diverse topics are covered, including cross-cultural relationships, depression, infertility, remarriage, and therapy with African-American, gay, lesbian, and later-life couples. Although every chapter is unique in its content, a consistent thread throughout the book is that couples exist in, and are strongly influenced by, a social context that has changed substantially in recent years. Thus, Papp writes that the goal of the volume is to ‘‘present work that demonstrates the many different ways in which the ideology of social awareness can be translated into clinical practice to meet the new challenges of our times’’ (p. 3). This book will likely appeal to clinicians who are looking for information on how to work with specific types of couples (e.g., couples experiencing domestic violence). As well, this book will be helpful to therapists who are interested in a general overview of some issues affecting couples. To this latter end, three of the 13 chapters describe issues that are central in the lives of many couples but which may not be explicitly recognized as potential sources of difficulty: worklife balance, technology, and time. For example, ImberBlack (Chapter 3) describes how the internet provides an opportunity for partners to seek out sexual gratification and communicate with anonymous others, presenting couples with new challenges (e.g., internet affairs). Moreover, Fraenkel and Wilson (Chapter 4) discuss how time pressures (e.g., hours spent working and commuting) can interfere with partners’ quality time together. These issues are highlighted with sensitivity to how both partners in a relationship may be affected. The authors clearly emphasize the impact of modern-day schedules and technology on couples and underscore issues that are likely relevant to countless couples. Most chapters are specific to certain types of couples (e.g., lesbian couples) and to couples with particular problems (e.g., infertility). As such, this book does not have to be read in its entirety. The variety of topics presented in this book represents a large range of issues for which couples seek therapy; a clinician is not likely to deal with all of these issues in his or her work and, as such, may choose to read parts of the book that best address his or her professional needs and interests. Specifically, however, for the reader interested in same-sex relationships, Sanders (Chapter 10) and Marvin and Miller (Chapter 11) present stimulating chapters on working with gay and lesbian couples, respectively. Within these chapters, the authors outline several factors that may be salient to same-sex couples, including the concept of family of choice, heterosexism, and the choice to become parents. Given the separate chapters devoted to gay and lesbian couples, readers gain perspective on some of the differences that may characterize male and female same-sex relationships and can obtain an appreciation for the various issues with which some same-sex couples may struggle. Although this book covers a wide range of issues, a systems-oriented perspective is integrated throughout. The editor and several of the contributing authors have educational backgrounds in social work and, in keeping with the aim of this book, carefully address the systemic factors and interpersonal context that contribute to couples’ difficulties. Similarly, this book maintains a broad perspective in that it K. B. Smith (&) C. F. Pukall Department of Psychology, Queens University, Humphrey Hall, 62 Arch St., Kingston, ON, Canada K7L 3N6 e-mail: 2kbs@queensu.ca

Supervision of Cross-Cultural Couples Therapy

This author discusses the importance of actively giving voice in clinical supervision and the therapy room to the code of silence around issues of ethnicity, gender, spirituality, and socioeconomic struggles that plague many cross-cultural couples. The author explores obstacles that collude with dominant oppressive discourses in supervision and therapy and provides suggestions for giving voice to issues of ethnicity, gender, spirituality, and socioeconomic status. The author offers strategies for entering a dialogue of cross-cultural exploration using narrative theory via a supervision case.

Do therapists address ethnic and racial differences in cross-cultural psychotherapy?

Ethnic and racial differences between client and therapist affect therapy processes and outcomes, but little is known about the extent to which therapists have dialogues about their differences in therapy. A survey on this topic was completed by 689 APA-licensed psychologists with experience conducting cross-cultural therapy. Most psychologists reported having such discussions, but with less than half of their cross-ethnic/racial clients. Therapists and clients were equally likely to initiate discussions. Reasons for discussing differences varied greatly. Therapists consistently described themselves as comfortable with and skilled at these discussions, and reported that discussions facilitated therapy. Therapists who were female, older, nonminority, less experienced with diverse clients, and viewed training as an important factor were more likely to have discussions about differences. Results point to the need to better understand if, when, and how ethnic and racial differences should be addressed in therapy. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Transference and Countertransference in Therapy with Lesbian Patients

ABSTRACT Like gender, sexual orientation is an important determinant of one's perception of human relationships, therefore influencing the therapeutic process. Through a framework derived from cross-cultural therapy literature, this article explores how lesbian patients' transferences are influenced by their perception of their therapists' sexual orientations and how therapists' countertransferences differ according to their sexual orientations. This analysis took shape through dialogue with heterosexual and lesbian therapists working in a variety of settings, some generic mental health settings and some lesbian, gay, and bisexual identified.

Culture Cannot Be Divorced From Psychiatric Care

Culture Cannot Be Divorced From Psychiatric Care

Lessons for an Outsider:A Family Therapist's Experience in Bolivia

This is a reflection on cross‐cultural therapy from the perspective of a practitioner and trainer who is an outsider to the culture in which she is working. The context is work in Bolivia. The therapist's own position, the process of interaction and the influences on the family of its context are considered. Cultural notes are provided to highlight what an outsider may represent, and the legitimacy of his involvement and intervention in family situations. Themes frequently encountered in therapy are reviewed including jealousy, violence and the changing societal relationship between men and women. The usefulness of getting to know the cultural background of such themes, including the possibility of exploring them anew in therapy, is examined. Finally, a case study is presented related to the themes which also illustrates the adaptation of process to fit patient's culturally related expectations.

For Whites Only

"Abstract: The following article is largely a stream-of-consciousness reflection on being a racially-conscious white therapist in racially divided America. It focuses specifically on working with African-American patients, addressing such themes as white anxiety, white skin privilege, lack of awareness of whiteness as a socio-political power construct, and white guilt. An illustrative case example takes the reader through how the themes listed shaped the therapist's subjectivity and alternately enhanced and inhibited the therapeutic pmcess. Key words: race relations, crosscultural therapy, whiteness, black-whi te relations, sociology of therapy."

BRIEF TREATMENT WITH A VIETNAMESE ADOLESCENT: INTEGRATING SELF PSYCHOLOGICAL AND CONSTRUCTIVIST MODELS

This paper explores psychotherapy between a North American female social worker and a Vietnamese adolescent. Self psychological and constructivist frameworks are integrated to accommodate clinical work with a client from a different culture. Clinical case material illustrates the multifaceted nature of cross-cultural therapy.