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Disadvantages in forming a therapeutic alliance
Disadvantages in forming a therapeutic alliance
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Summary The article, “Cultural difference and the therapeutic alliance: An evidence- based analysis by Melba J. T. Vasquez seeks to address the issue of unintentional biases in psychotherapy and how the therapeutic alliance, a significant factor in a positive therapeutic outcome, can be either positively or negatively affected by a therapist's decision to overcome such biases. Interference with the therapeutic alliance can cause ethnic minority individuals to cease attending therapy. It is evident from the abstract that this is not a simple issue, however, the author effectively addresses and explains several significant components of this problem. For instance he begins by giving an explanation as to what psychotherapy is, what it entails and also its effectiveness. He then highlights the concern that ethnic minorities unfortunately underutilize psychotherapy services and those who do utilize it have a higher rate of dropping out. A significant factor contributing to high drop out rates is that there is an unfortunate existence of unintentional biases which can extend to the process of psychotherapy. When unintentional biases are apart of …show more content…
According to Orlinsky, Ronnestad and Willutzki (as cited in Vasquez, 2007) the therapeutic alliance is defined as the quality of involvement between a therapist and their client and Warner and Greenberg (as cited in Vasquez, 2007) also describe this alliance as being one of the most important factors in the effectiveness of therapy. The author then goes on to discuss the issues that may interfere with the therapeutic alliance of clients who are ethnically different from their counsellor. He states that this inexperience may be due to cultural misunderstandings and miscommunication between counsellor and client. While such issues exist, Vasquez (2007) offers many suggestions to help counsellor prevent experiencing these
It is pertinent to study the history of racial oppression when preparing to counsel a client from an ethnic minority if the counselor is from the majority culture. The problem is it would be difficult to examine the complete history and would be highly impossible especially in a short time. However, a therapist can gain knowledge of some of the essentials of history such as, religion, family structure, and background information. If the therapist or counselor is uncomfortable counseling these individuals he/or she can refer the client to someone who has more knowledge or has the same cultural background as the client. For instance, a therapist must become aware of the sociopolitical dynamics that form not only their clients’ views, but their own as well. Racial and cultural dynamics may interfere into the helping process and cause misdiagnosis, confusion, pain and reinforcement of biases and prejudices towards their client.
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures shares the journey of cultural illiteracy from the Hmong and American side. Fadiman states, “In 1995, for the first time, the national guidelines for training psychiatry residents stipulated that they learn to assess cultural influences on their patients’ problems,” (Fadiman 270). Though the unfortunate events that occurred were definitely able to avoid now, at the time, there was no standard set of actions and procedures to take in order to provide the best health care to different cultures. Fadiman truly succeeded in showing the reader that good intentions and compassion must be weighed more heavily when analyzing events and the consequences must be met with an objective eye.
“Cultural competence is the ability to engage in actions or create conditions that maximize the optimal development of client and client systems” (Sue & Sue, 2013, p. 49). Multicultural competence includes a counselor to be aware of his or her biases, knowledge of the culture they are evaluating, and skills to evaluate a client with various backgrounds (Sue & Sue, 2013). Client assessment involves gathering information pertaining to the client’s condition. Making a culturally responsive diagnosis involves using the DSM-IV-TR axis (Hays, 2008). Following the axis backwards is ideal to discovering the client’s diagnosis, understanding the client’s ADDRESSING outline will help to come to a closer resolution for a diagnosis.
Counselors today face the task of how to appropriately counsel multicultural clients. Being sensitive to cultural variables can be conceptualized as holding a cultural lens to human behavior and making allowances for the possibility of cultural influence. However, to avoid stereotyping, it is important that the clinician recognize the existence of within-group differences as well as the influence of the client’s own personal culture and values (Furman, Negi, Iwamoto, Shukraft, & Gragg, 2009). One’s background is not always black or white and a counselor needs to be able to discern and adjust one’s treatment plan according to their client.
Working as a research nurse at the Ohio State University, I often encounter patients that
A therapist will face problems, issues and client troubles everyday. The professional must understand how their client relates to the world around them. These feelings and ideas affect how the client sees the problem and how they respond to their situation. Their actions, in turn, have bearing on individual thoughts, needs, and emotions. The therapist must be aware of the client's history, values, and culture in order to provide effective therapy. This paper will outline and provide information as to the importance of cultural competence and diversity in family therapy.
Race and ethnicity can influence a client’s experience of self and others in a variety of ways. A client’s personal race and ethnicity can influence his or her experience within the context of therapy through the set of beliefs he or she brings into the room. This set of beliefs and customs influences how he or she views therapy and whether there is motivation to be there. If the client’s culture does not usually seek therapy for their problems, or even believe in mental illness, it is likely the client will have apprehensions about trusting or speaking to the clinician. If the clinician is not aware of this possibility, the clinician may wonder why the client is in therapy if he or she will not speak or allow rapport to be built. A responsible clinician will take this into consideration.
programs, particularly with treatment initiation and retention. Hiring qualified staff of the same ethnic background may dramatically increase patient access and initiation into treatment. In addition, if the treatment provider is not of the same ethnic background, it is best that he or she take on an inquisitive role and not make any ethnocentric assumptions based on his own cultural heritage. The goat of the clinician should be to uncover social cultural issues that will affect acceptance, retention, and ultimately, treatment outcome". (Patrick Abbott, MD and Duane M. Chase. n.d para,
Research has shown that a strong therapeutic alliance is necessary for establishing a beneficial contact between the therapist and the client. If the therapist does not encourage the creation of a reliable therapeutic alliance from the beginning of the treatment, it will be hard to develop a constructive relationship with the client later. Establishing the therapeutic alliance will increase the chances of achieving the goal of the treatment because the clients will be willing to cooperate if they trust and respect the therapist. Clients are not likely to cooperate with therapists who impose their authority aggressively. Instead of imposing their authority on the patient, therapists should develop work with their patients by building a mutual relationship based on trust, understanding, and respect for the client.
Smith, T. B., Rodríguez, M. D., & Bernal, G. (2011). Culture. In J. C. Norcross (Ed.), Psychotherapy relationships that work (2nd ed.). New York: Oxford University Press.
It is interesting to note according to Raskin et al. ( 2011), “Our basic practice [client centered therapy] remains true to the core conditions no matter who our client may be. We also assert that our ability to form an initial therapeutic relationship depends on our own openness to and appreciation of respect for all kinds of difference” (p. 183). I believe that the cultural diversity that CCT maintains is important in a multiplicity open therapeutic environment. The implications for a non discriminatory form of therapy are that it can be used across populations. This allows for broader use of this theory and the chances for positive outcomes is increased because the availability.
Kim, B. S. K., Ng, G. S., & Ahn, A. J. (2005). Effects of client expectation for counseling success, client-counselor worldview match, and client adherence to asian and european american cultural values on counseling process with asian americans. Journal of Counseling Psychology, 52, 67-76.
The assertion has appeared repeatedly in the literature that it is unethical for counselors to provide clinical services to clients who are culturally different from themselves if the counselors are not competent to work effectively with these clients (e.g., Corey, Corey, & Callanan, 2003; Herlihy & Watson, 2003; Lee, 2002; Pedersen, Draguns, Lonner, & Trimble, 2002; Remley & Herlihy, 2005; Vontress, 2002). Historically, however, counselors have been slow to recognize a connection between multicultural competence and ethical behavior. Multiculturalism and ethical standards both emerged during the 1960s as separate strands of development within the counseling profession. Multicultural counseling evolved from a growing awareness that discrepancies between counselor and client were resulting in ineffective service delivery and early termination of treatment for ethnic minority clients (Atkinson, Morton, & Sue, 1998” (p.99). Prior to this form of counseling, counseling was most effective for Caucasians. However, as time pasted and theories for minorities improved the code of ethics began to improve as
There are different perspectives, however, which put stress on various aspects of culture and try to identify its boundaries and its substitutes. Some regard culture as separate entity from demographic factors, some point out acculturation as one of the obstacles, which makes culture difficult to identify, some show how an intimate and meaningful relationship between a counsellor and a culturally different client to be established. In this essay I will be discussing what the different concepts of understanding of culture in Counselling are, by examining different authors and perspectives and evaluating their strengths and weaknesses.
Firstly, beliefs and attitudes infer the counselor’s ability to move beyond cultural unawareness for safeguarding that their personal biases, values or problems will not affect their ability to work with culturally diverse clients (Corey, 2013). In the same way, culturally skilled counselors are cognizant of the fact that “cultural self-awareness and sensitivity to one’s own cultural heritage” plays an integral role in the helping process (Corey, 2013, p.