An Investigation of European American Therapists’ Approach to Counseling African American Clients

Abstract

Interviews were conducted with 9 European American psychologists, asking them to recall their first 12 counseling sessions with a current or recent successful case with an African American client. Using consensual qualitative research (CQR) methodology, the psychologists revealed that they generally attended to differences in race between themselves and clients directly and openly within the first two sessions. This was done to acknowledge this difference and convey to the client comfort and trust; psychologists also intended to engender client trust and participation in therapy. The psychologists saw race as a central component to be discussed and continually attended to in establishing and maintaining a trusting and solid working relationship. They typically saw race-related issues as relevant to clients'concerns. Despite wide variability in theoretical orientations and variety of client presenting problems, they typically reported using Rogerian core skills to engage the client and establish the relationship. However, they also reported using more culture-specific and sensitive interventions to deepen and strengthen the therapy relationship. These interventions included relying on their level of racial identity development to understand the client, being attuned to the client's racial identity development and worldview, and attending to client reports of racism.

Ethnicity and the therapeutic relationship: views of young people accessing cognitive behavioural therapy

“…This is consistent with the cultural competency literature that highlights the benefit of adding techniques to the existing model within which the therapist and BME client are working (Fuertes et al, 2002), in this case CBT. An additive approach is preferable to replacing techniques with supposedly culturally appropriate equivalents (Sue, Zane, Nagayama-Hall, & Berger, 2009).…”

“…Interestingly, this mirrors the concerns of therapists in addressing racial differences between client and therapist in adult psychotherapy settings (Fuertes et al, 2002;Maxie, Arnold, & Stephenson, 2006), again suggesting that therapists share the same concerns as clients. The participants suggested that asking questions at the wrong time (for instance the first session) would make the client feel uncomfortable and less likely to open up about their background and how it was important (or not) to them.…”

“…The young people shared some of the same concerns that therapists have previously raised regarding the possible negative implications of addressing ethnicity if it is not managed well (Fuertes et al, 2002;Maxie et al, 2006;Messent & Murrell, 2003).…”

“…For Umair, ethnicity was not important in understanding his presenting difficulties but important in informing interventions as he described how "one of the techniques I'm using now is based on religion". Research suggests that it is common for clients not to view their ethnicity as important or relevant to their difficulties until it emerges as part of the reflective process of therapy, often initiated by the therapist (Fuertes, Mueller, Chauhan, Walker, & Ladany, 2002;Knox et al, 2003).…”

Individual and cultural‐diversity competency: Focus on the therapist

“…Findings indicate that therapists (Fuertes, Mueller, Chauhan, Walker, & Ladany, 2002) with a knowledge of racial-identity theory (Helms, 1990) and awareness of its central role in their clients' lives were able to make statements about their clients' racial identity. They also were able to describe their clients' interpersonal concerns as deeply intertwined with factors such as racism, homophobia, and poverty.…”