55-5 How do culture and values influence the therapist-client relationship?

All therapies offer hope, and nearly all therapists attempt to enhance their clients’ sensitivity, openness, personal responsibility, and sense of purpose (Jensen & Bergin, 1988). But therapists also differ from one another and may differ from their clients (Delaney et al., 2007; Kelly, 1990).

These differences can become significant when a therapist from one culture meets a client from another. In North America, Europe, and Australia, for example, most therapists reflect their culture’s individualism, which often gives priority to personal desires and identity, particularly for men. Clients who are immigrants from Asian countries, where people are mindful of others’ expectations, may have trouble relating to therapies that require them to think only of their own well-being. Such differences help explain minority populations’ reluctance to use mental health services, and their tendency to prematurely terminate therapy (Chen et al., 2009; Sue, 2006). In one experiment, Asian-American clients matched with counselors who shared their cultural values (rather than mismatched with those who did not) perceived more counselor empathy and felt a stronger alliance with the counselor (Kim et al., 2005). Recognizing that therapists and clients may differ in their values, communication styles, and language, all American Psychological Association–accredited therapy training programs now provide training in cultural sensitivity and welcome members of underrepresented cultural groups.

Another area of potential values-related conflict is religion. Highly religious people may prefer and benefit from religiously similar therapists (Masters, 2010; Smith et al., 2007; Wade et al., 2006). They may have trouble establishing an emotional bond with a therapist who does not share their values. Because clients tend to adopt their therapists’ values (Worthington et al., 1996), some psychologists believe therapists should divulge their values. Today’s professional training programs also seek to train therapists from diverse backgrounds who can relate, with sensitivity, to diverse clients.

Finding a Mental Health Professional

55-6 What should a person look for when selecting a therapist?

Life for everyone is marked by a mix of serenity and stress, blessing and bereavement, good moods and bad. So, when should we seek a mental health professional’s help? The American Psychological Association offers these common trouble signals:

In looking for a therapist, you may want to have a preliminary consultation with two or three. College health centers are generally good starting points, and may offer some free services. You can describe your problem and learn each therapist’s treatment approach. You can ask questions about the therapist’s values, credentials (TABLE 55.1), and fees. And you can assess your own feelings about each of them. The emotional bond between therapist and client is perhaps the most important factor in effective therapy.

681