multicultural considerations in psychotherapy

PSGY1009: Psychological Approaches to Therapy

  • Lecturer: Dr. Kate Bailey

  • Room: B10, School of Psychology

  • Email: kate.bailey@nottingham.ac.uk

  • Lecture Title: Multicultural Considerations in Psychotherapy

Overview of Multicultural Considerations in Therapy

Learning Objectives

  • Dodo Bird Effect: Explain and connect it to psychological therapies.

  • Humanistic Psychotherapies: Evaluate their effectiveness and target demographics.

  • Monocultural Therapies: Discuss main issues and propose solutions for culturally sensitive practices.

Do Humanistic Psychotherapies (HPs) Work?

General Effectiveness

  • Carl Rogers is regarded as the significant figure in psychotherapy research.

  • Humanistic Psychotherapies have received less support from NICE (National Institute for Health and Care Excellence) as of Khele (2008).

  • Rosenzweig (1936): Presents the Dodo Bird effect, suggesting common factors in therapeutic outcomes rather than specific methodologies.

Evidence and Meta-Analyses

  • Wampold (2006): Found comparable effect sizes across all therapies, reinforcing the Dodo Bird effect.

  • Common Factors Research: Key elements such as empathy, positive regard, and genuineness are highlighted.

Challenges for Humanistic Psychotherapies (HPs) in Specific Disorders

Evidence-Based Treatment Criteria

  • Gold-standard evidence (Randomised Controlled Trials) is often required for therapies to qualify as Evidence Based Treatments (EBTs).

  • This model is based on medical biomedical frameworks insufficiently suited for Humanistic psychotherapies.

Treatment Approach Shift

  • Movement from medical models towards comprehensive healing—treating individuals not merely their symptoms.

  • Traditional techniques do not wholly encapsulate the humanistic approach.

Effectiveness for Depression

  • King et al (2000): Meta-analysis shows efficacy of Humanistic approaches for mild to moderate depression.

Comparative Outcomes

  • Person-Centred Therapy (PCT) and Cognitive Behavioral Therapy (CBT) showcased equal effectiveness in reducing depressive symptoms at 4 months; however, at 12 months, differences among treatment groups diminished.

  • Higher patient satisfaction noted in PCT at 12 months but not statistically significant outcomes.

Culturally Specific Interventions

McArthur et al (2013) Study

  • School-Based Humanistic Counselling (SBHC): Compared with wait-listed controls, showed potential to reduce psychological distress among youth aged 13-16.

  • Findings included significant changes in psychological distress but noted limitations such as small sample size and lack of diversity.

Pearce et al (2017) Later Study

  • Expanded upon McArthur's research with a more diverse pool showing only short-term effectiveness of counseling approaches.

  • Freire et al (2005): Indicated observable improvements in child–staff relationships in a residential shelter; however, lacking in rigorous RCTs.

Understanding Multiculturalism in Psychotherapy

Definition of Culture

  • Culture encompasses shared values and behaviors, including race, age, gender, and socio-economic status.

  • Ethically crucial for therapists to cultivate cultural sensitivity throughout treatment.

Historical Origin Issues in Psychotherapy

  • Key figures in psychotherapy primarily hail from Western backgrounds (e.g., Carl Rogers, Freud), creating potential drawbacks in addressing contemporary multicultural needs.

Potential Bias and Its Implications

Mainstream Psychotherapy Limitations

  • Predominantly White, male-rooted models can unintentionally foster ethnocentrism, limiting efficacy for minority groups.

  • Potential avoidance by minority clients from mainstream therapies based on perceived disconnect or cultural insensitivity.

Worldviews and Values

Distinctions Between Cultures

  • Core values: Individualism vs. Collectivism, Cognitivism vs. Emotionalism, etc.

  • Influence of worldviews on therapy outcomes and client relations.

Derald Sue's Contributions

  • Recognized for pioneering multicultural counseling, focusing on microaggressions and implicit biases affecting therapy engagement.

  • Traditional approaches can impose cultural oppression if therapists are not aware of their biases and conditioned worldviews.

Approaching Cultural Competence

Strategies for Developing Competence

  • **Sue et al (1998) Framework ** Components:

    1. Awareness of one’s biases.

    2. Understanding clients’ diverse worldviews.

    3. Developing tailored strategies and techniques for communication and therapy.

Issues of Racial Micro-Aggressions

  • Microaggressions can undermine therapy, necessitating therapist awareness and addressing their own heritage impacts.

  • Recognizing white privilege and changing therapist-client dynamics through cultural humility.

Summary & Conclusion

  • The Dodo Bird effect indicates a convergence in therapy outcomes across diverse methods.

  • While Humanistic therapies are debated regarding evidence strength, there is growing support for their effectiveness, mainly with depression and minority groups.

  • Challenges present in mainstream models necessitate adaptations and enhanced cultural competence for effective practice.

Suggested Readings & Resources

  • Nelson-Jones, R. Theory and Practice of Counseling and Psychotherapy. Chapter 16.

  • Corey, G. Theory and Practice of Counseling and Psychotherapy. Chapter 2.

  • Cooper, M. Essential Research Findings in Counseling and Psychotherapy. Chapter 3.