A practice‐based study of cultural humility and well‐being among psychotherapy clients

Abstract

One trend in psychotherapy research involves examining client factors to better understand change. Some have framed client factors as virtues. Humility is one virtue that has gained attention with evidence that suggests humility may help facilitate therapeutic change. A specific type of humility, cultural humility, however, has not been closely examined as a client factor. Cultural humility is a relational virtue that addresses an individual's ability to be open towards cultural differences and can be helpful in buffering diverse relational dynamics (e.g., student and teacher, family members and friends with different beliefs). In this study, we examined client change in cultural humility and well-being using group-based trajectory modelling. We also examined differentiation as a predictor of trajectory membership and compared trajectories on levels of symptoms. Results suggested that a subgroup of clients showed significant increases in cultural humility and well-being. Further analyses found that clients with higher levels of initial differentiation were more likely to belong to the growth trajectory. This same trajectory also decreased in symptoms over time.

A practice‐based study of relational virtues and alliance correspondence in psychodynamic psychotherapy

“…The chief implication for clinical practice revolves around the tension between using implicit relational processes for virtue growth relative to explicitly targeting virtues, whether the latter involves direct in-session conversation and/ or the practice of virtue interventions in and/or outside of session. Either way, our findings highlight the clinical utility of assessing client strengths (Summers & Barber, 2010) and directly monitoring virtue engagement to track progress during treatment (Choe et al, 2023). It is also likely that actual in-session content and process involves synthesis of implicit and explicit virtue engagement, and future research could explore this by coding recorded sessions and/or conducting qualitative interviews focused on clinician and client experience of in-session exchanges.…”

“…Similarly, Diniz et al (2023) identified only two studies for their meta-analysis of 64 studies that addressed the effectiveness of a gratitude intervention to improve symptoms and well-being in the context of psychotherapy. In addition, Wade et al (2014) Another class of more recent research frames virtues as client factors that implicitly emerge within effective alliance processes and co-occur with gains in symptoms and well-being (Choe et al, 2023;Jankowski, Hall, et al, 2021). In this line of scholarship, virtues are modeled as outcomes, and typically, symptoms and/or well-being are also modeled.…”

“…We expanded on the Choe et al (2023) finding for the current study. Specifically, we built on their bi-factor S•I-1 model (Eid et al, 2017) to compare bi-factor exploratory structural equation models.…”

“…Another class of more recent research frames virtues as client factors that implicitly emerge within effective alliance processes and co‐occur with gains in symptoms and well‐being (Choe et al, 2023; Jankowski, Hall, et al, 2021). In this line of scholarship, virtues are modeled as outcomes, and typically, symptoms and/or well‐being are also modeled.…”

“…By virtues , we mean developmental strengths or aspirational “excellences of character” (Bloomfield, 2022, p. 50). We operationalized virtues using a recently developed measure of v irtue engagement (Choe et al, 2023), with virtue engagement referring to prosocial behaviors in particular life situations. Virtue engagement draws on the virtue ethics notions of active conditioning and sphere of action.…”