Family Traditions, Cultural Values, and the Clinician's Countertransference: Therapeutic Assessment of a Young Sicilian Woman

Abstract

Despite recent advances in models and instruments to understand the role of a client's cultural background, clinical psychologists are not immune to implicit cultural biases that are potentially damaging to the therapeutic alliance. In this article, I present a Therapeutic Assessment with a young Sicilian woman conducted in a university-based student clinic in Italy. During the assessment, I assumed that because we were both Italians, my client shared my perspective (northern Italian) about family and individual values, which resulted in a therapeutic impasse when I responded on the basis of my individual and culturally shaped view of interpersonal and family relationships without appreciating important differences between my own and my client's microcultures. To overcome the impasse, I had to openly acknowledge such differences and reorient myself to my client's goals. I discuss the core processes involved in such a repair in the context of a cross-cultural psychological assessment.

Client-focused assessment and intervention: Tailoring the work to the client.

“…A series of single-case experiments have also demonstrated significant symptom improvement following the initiation of TA in adults (Aschieri & Smith, 2012;Hinrichs, 2016;Smith & George, 2012;Tarocchi et al, 2013). Case studies have been published documenting TA with diverse populations and presenting problems, for example, with a young African American foster child in a community clinic and in an inpatient setting with a man diagnosed with narcissistic personality disorder (e.g., Fantini, 2016;Guerrero et al, 2011;Hinrichs, 2016). In these case studies, improvement was measured with respect to symptom and functioning domains tied to the initial assessment questions identified collaboratively by the client and assessor (e.g., "I am hard on myself" or "I recognize others' love and affection for me" as rated on a Likert scale; Aschieri & Smith, 2012).…”

Therapeutic Assessment as an Interventional Model of Psychological Evaluation: Case Study

“…Therapeutic Assessment (TA) is a model of interventional psychological assessment that adopts a collaborative approach and has a semi-structured systematization (Durosini, Tarocchi & Aschieri, 2017;Fantini, 2016;Finn, 2017;Saeger, Bartak, Eder & Hamphus, 2016;Villemor-Amaral & Resende, 2018).…”

“…The third step concerns the intervention sessions, in which the assessor aims to bring the problematic behaviors of the client to the service room, thereby seeking to identify them, analyze them, and elaborate possible changes (Fantini, 2016;Finn, 2017). Fantini (2016) points out alternatives used to promote the practical experience that the interventional sessions propose, such as the use of psychodramatic techniques, games, or test stimuli as techniques.…”

“…The third step concerns the intervention sessions, in which the assessor aims to bring the problematic behaviors of the client to the service room, thereby seeking to identify them, analyze them, and elaborate possible changes (Fantini, 2016;Finn, 2017). Fantini (2016) points out alternatives used to promote the practical experience that the interventional sessions propose, such as the use of psychodramatic techniques, games, or test stimuli as techniques. These sessions are prepared based on elements derived from the conflicts addressed by the client, their defenses, and their issues, which can be discussed and, to the extent that the client understands them, generalized for his or her life.…”

“…Peters et al (2008) show that the Therapeutic Assessment process is successful when the client feels understood, evaluated, and respected by the professional and realizes that the answers to the initial questions produced some significant change for the better. Case studies on TA with adults have been developed in several countries (Aschieri & Smith, 2012;Chudzik, 2015;Durosini, et al, 2017;Fantini, 2016;Finn, 2017;Hinrichs, 2015) and highlighted the benefits that the evaluation process provided to customers.…”