Attending to the intersectionality and saliency of clients’ identities: A further investigation of therapists’ multicultural orientation.

Abstract

Psychotherapy clients often hold multiple and varied cultural identities, and it is important for therapists to attend to the intersectionality of clients' cultural identities, as well as the saliency of these identities. However, to date, few studies have considered the saliency of clients' multiple identities and how this may impact clients' perceptions of cultural processes in therapy. Therefore, this study utilized polynomial regression and response surface analysis to operationalize and examine congruent and discrepant effects between the saliency of clients' multiple identities and their perceptions of their therapists' cultural humility and cultural missed opportunities. Data for this study consisted of 87 clients who received individual counseling services at either a university counseling center or training clinic at two large universities in the United States. As hypothesized, results indicated significant discrepant effects between the saliency of clients' first and second most important cultural identities and perceptions of their therapists' cultural humility and cultural missed opportunities. Specifically, clients' ratings of their therapist's cultural missed opportunities were lowest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. Similarly, clients' ratings of their therapist's cultural humility were highest when they reported either a) high saliency of cultural identity one and low saliency of cultural identity two, or b) low saliency of cultural identity one and high saliency of cultural identity two. Public Significance StatementThis study found that when the salience of clients' two most important cultural identities was discrepant (i.e., high-low or low-high), they perceived their therapist to be high in culturally humility and low in cultural missed opportunities. Therapists should acknowledge that clients often hold multiple cultural identities and that the saliency of these identities may differ in meaningful ways. Therapists should attend to this complexity from a multicultural framework to engage in culturally responsive care.

Changes in client attachment in relation to client distress: A response surface analysis.

“…We considered a client's attachment scores at time T as one predictor (x) and their scores at time T + 1 as the other predictor (y); the outcome variable is client distress scores at T + 1 (z). Anders et al (2020) asserted that for a PRRSA, at least 10% of the instances should be represented in each type of change. In preliminary analyses, we thus examined the percentages of time periods that Anxiety and Avoidance changed among all time periods.…”

Windows of cultural opportunity: A thematic analysis of how cultural conversations occur in psychotherapy.

“…The literature investigating cultural opportunities is expanding, shining light on how cultural conversations are (or are not) taking place in individual therapy (Anders et al, 2020; Drinane et al, 2018; Owen et al, 2016); group therapy (Kivlighan et al, 2019; Kivlighan & Chapman, 2018) and clinical supervision (Hook et al, 2016; King et al, 2020; Zhao & Stone-Sabali, 2020). Researchers have proclaimed the attunement to cultural opportunities in individual therapy as important for clients and can be particularly helpful when considering cultural factors for specific groups (Adams & Kivlighan, 2019; Gafford et al, 2019).…”

“…A recent study investigated the relationship between how salient clients rate their identities to be and their perception of their therapists’ cultural humility and missed cultural opportunities (Anders et al, 2020). Findings revealed that clients who reported only one identity as high in saliency perceived their therapists as more culturally humble and willing to explore cultural aspects of their identity.…”

“…However, clients who identified two or more identities as high in saliency reported their therapists as less culturally humble and having missed more cultural opportunities. Researchers pose that clients with more complex identity constellations may require a richer exploration of identities they hold (Anders et al, 2020). Thus, an exploration of how cultural conversations are occurring and being engaged with during real counseling sessions may provide insight as to how we can tailor interventions to better explore the numerous identities our clients hold.…”

“…First, while the subjective experiences of therapists and clients are important areas to explore, we were interested to learn how windows of opportunity actually arose in session. Prior studies have utilized methods, such as self-report, to investigate cultural opportunities (Anders et al, 2020; King & Borders, 2019; Owen et al, 2016), however, evidence suggests that therapists may not always be aware of when cultural opportunities occur in session (Owen et al, 2016). Moreover, cultural opportunities have been defined as markers or indicators of cultural content in session (Owen et al, 2016).…”