Beyond Harms

Abstract

Wendt, Gone, and Nagata raise some very important questions about harm in psychotherapy and initiate a valuable dialogue between scholars of potentially harmful therapy and multicultural counseling and psychotherapy. This comment enlarges upon the authors' view that harms cannot be understood independently of goods by providing an argument that goods have an inherent place in psychotherapy and in multicultural viewpoints. The goods of psychotherapy (e.g., justice, respect) are ordinary and widely endorsed rather than esoteric or objectionable. Identifying these goods makes it possible to organize them into a coherent hierarchy that enables an integration of the primarily individual goods of standard psychotherapy and the primarily communal goods of a multicultural perspective. This can facilitate a mutually informative and enriching dialogue between scholars from these two domains. The hope is to encourage a more open discussion of the goods of psychotherapy, thereby fostering a more reflective, progressive discipline.

Potentially Harmful Therapy and Multicultural Counseling

“…These include the assessment of effectiveness of graduate training in multicultural competence, the difficulty of parsing treatment-induced harm from other causes of client deterioration (including anticipated short-term exacerbations of symptoms), the importance of predicting which clients may benefit from and which may be harmed by certain treatments, and the need for practitioners to recognize and seek to remedy inevitable ruptures in the therapeutic alliance. Fowers, Anderson, Lefevor, and Lang (2015, this issue) elucidated a crucial point that we could only barely touch upon in our original article: Any conceptualization of harm implies what is "good," and it is imperative for the discipline to be explicit about what these "goods" are. Although we agree that this training is critically important, individual practitioners retain minimal facility and opportunity to mitigate the ethnocentrism that is embodied in individual treatment approaches, organizations, and society.…”

Experiences of Transgender Couples Navigating One Partner’s Transition: Love Is Gender Blind

“…The gender transition process is a systemic and familial experience, as individuals close to trans people are also impacted by gender changes, including romantic partners (Dierckx et al, 2016;Jackson, 2013). It is essential that family and couples counselors who work with transgender individuals and their partners understand the unique challenges and strengths that couples may experience through transition in order to provide competent care and potentially reduce harm experienced by this vulnerable population, often subject to disparate and discriminatory health care (Fowers et al, 2015;James et al, 2016). Without empirical support contributing to counselors' understanding of diverse groups that challenge oppressive majority values of what is "normality," multicultural sensitive practice "risks becoming an empty political value" (Morales & Norcross, 2010, p. 823).…”