Introduction: In 1976, Erikson characterized adolescence as a special phase of development marked by the construction of identity, where a containing and understanding family environment is crucial, as well as the socio-cultural context, so immigration can act as a destabilizer. Through a case report, it is intended to address the role of culture in the development of emotional, behavioural and identity problems in immigrant adolescents, and also reflect on its impact on the therapeutic alliance and the need for an intercultural approach in the care of this population. Case Presentation: 16-year-old black skin Angolan teenager, who immigrated to Portugal at the age of 11, being displaced from her extended family. At the age of 14, she began to present self-injurious behaviours and developed depressive symptoms, having been referred to a Child and Adolescent Psychiatric consultation after voluntary drug intake when she was 16 years old. Throughout the observations, the intercultural conflict, the feeling of not belonging and incomprehension were noticeable. In one of the consultations, in the presence of an African doctor, she presented a relaxed attitude, spontaneously addressed sociocultural aspects that she believes are at the genesis of the current symptoms. Conclusion: Intrapersonal, interpersonal and cultural factors influence the identity construction process, and conflicts in these dimensions can lead to behavioural and emotional problems. Given that the therapeutic alliance is important for the treatment, investing in intercultural training of mental health professionals can be beneficial to address immigrants’ mental health problems.