Psychodynamic Alliance: A Case Study

The therapeutic alliance, or working alliance, may be defined as the quality of involvement between therapist and client through task teamwork, mutual goal settings and strong rapport established (Orlinsky, Ronnestad & Willutzki, 2004). Indeed, the therapist’s role is an important contributing factor to the therapeutic relationship as a positive working alliance will greatly be determined by the skills they portray (Ornstein & Ganzer, 2005). Achieving a therapeutic alliance depends largely upon the therapist’s ability to communicate emphatic understanding of the client’s feelings and belief systems. However, disparities in assessing clients may arise when both clients and therapists belong to different cultures due to the lack of understanding

It has been suggested that processes within psychodynamic therapies are integral to the therapy experience may be affected by cultural differences. People being treated by a health professional of a dominant culture may develop a transference based on the cultural divide generated by conflict between two cultures (Benson & Thistlethwaite, 2008). Therapist may be deemed as symbolizing past traumatic experiences or socialization that the client or the client's identity group had encountered with the therapist's identity group (Helms & Cook, 1999). This suggests a negative transference that is derived from the patient's expectations of the therapist, based on the therapist's cultural group. Clients may face ‘cultural traumatization’ as they fear being oppressed by the therapist. Similarly, cultural-based countertransference refers to therapists’ culturally held assumptions, stereotypes, norms, beliefs, and values; attitudes related to race, ethnicity, and gender (Fauth, 2006). Therapist may be responding to the client’s transference and/or coping with their individual reactions that have nothing to do with the client but are triggered by the client’s appearance or other aspects of the therapy process. Thus, a lack of awareness of culture-based reactions may significantly impact therapists’ ability to provide

Client and therapist are at risk of communication breakdowns and the accuracy of assessment will be affected due to the language and cultural gap (Cravener, 1992). Most cultures have explicit or implicit taboos about relationships and their confidentiality – people are less likely to talk about trauma if there is a cultural gap causing them to fear being misunderstood or judged because of their experiences – which occurs mainly among Asian cultures like the Chinese or Cantonese population (Joice & Walker, 2010). Russell (1988) surfaced the importance of being sensitive to two related psycholinguistic phenomena such as the detachment effect and code switching. The detachment effect refers to phenomenon of limited expression of affect and reduced access to developmental events between languages for people who speak more than one language (Cravener, 1992). Events that occurred before clients speak the English language may be forgotten or the inability of client to express emotionally significant events that happened in childhood accurately in English. Rozensky and Gomez (1983) highlighted that bilingual clients present affective communication difficulties due to a split between both affective experiences and developmental issues that took place in the mother tongue and