Developing a model of broaching and bridging in cross-cultural psychotherapy: Toward fostering epistemic and social justice.

Abstract

Epistemic and social injustice occurs when therapists implicitly and explicitly impose personal, professional, and institutional power onto clients, and dismiss client experience which is embedded in cultural identity and social location. Despite research evidence highlighting the positive impact of broaching in cross-cultural psychotherapy, questioning the rationale and barriers to broaching is paramount. Drawing from scholarship on epistemic in/justice, we argue that the very existence of marginalization of a client in the life and in the therapy exemplifies epistemic injustice. Epistemic injustice bears two types-testimonial and hermeneutic injustice. When clients' experience of marginalization is decentered or discredited, testimonial injustice occurs. By not providing clients with opportunities to share this experience in therapy, there is little shared understanding cultivated in the cross-cultural dyad, contributing to hermeneutic injustice. Thus, epistemic in/justice requires broaching not as an option but as an integral part of therapy. Synthesizing scholarship in cultural competence, humility, intersectionality, and antioppressive practice, we define broaching as the therapist's tasks for intentional understanding of the cultural aspects and systemic oppression in the client's life-in-context. A therapist who is broaching is aware of cross-cultural similarities and differences and the workings of power in the therapy dyad and makes deliberate efforts to demonstrate this understanding to the client which includes explicit discussion in sessions. We propose pathways, dimensions, foci, and timing of ongoing broaching and bridging cross-cultural encounters in therapy. Lastly, we discuss the implications of broaching and bridging while situating this work as promoting epistemic and social justice in therapy encounters. Public Policy Relevance StatementIn working with individuals who come from different cultural experiences, it is critical for therapists to acknowledge the presence of cultural similarities and differences and power disparities in therapy dyads. In order to understand how systemic oppression influences the client's experience, we must explicitly broach and bridge similarities, differences, and power differentials in therapy conversations as the pathway toward building a therapeutic alliance with the client. This process is embodying epistemic and social justice while respecting the client as a fully cultural human being. By integrating philosophical, theoretical, and empirical evidence of broaching and bridging in therapy, this article proposes a comprehensive Broaching and Bridging Model to guide therapists to initiate socially and epistemically just conversations with clients in health and social services. Centering epistemic justice in cross-cultural psychotherapy opens opportunities to not only foster justice in clinical encounters but also to allow a genuine space for surfacing and confronting intersectional systemic oppressions embedded in mental health care systems and policies.

Pedagogical Methods of Teaching Social Justice in Social Work: A Scoping Review

“…However, defining social justice and determining what constitutes key domains of social justice-oriented practice and education have been topics of debate among social work scholars (O’Brien, 2011; Reisch, 2002) and professional organizations (e.g., National Association of Social Workers [NASW]). For example, in addressing the issue of poverty, Craig (2002) defines social justice as “a framework of political objectives, pursued through social, economic, environmental, and political policies, based on an acceptance of difference and diversity ” (p. 671, italics added), whereas other scholars underline other essential dimensions such as, racial justice (Wagaman, Odera, & Fraser, 2019), equity and fairness (O’Brien, 2011), distributary justice (Miller, 1999), and epistemic justice (Lee, Greenblatt, Hu, Johnstone, & Kourgiantakis, in press; Johnstone & Lee, 2021). Due to “the wide range of social conditions that fall under the social justice or human rights umbrella, NASW has identified a set number of issues on which to focus” (NASW, 2022, para.…”

Microskills of broaching and bridging in cross-cultural psychotherapy: Locating therapy skills in the epistemic domain toward fostering epistemic justice.

“…In a previous publication, we discussed how testimonial and hermeneutic injustice may occur in the process of not broaching and bridging in cross-cultural psychotherapy (Lee et al, in press). In this article, we focus on how epistemic domains are claimed and negotiated in everyday conversations between a client and therapist who come from different cultures and multiple intersectionalities during the broaching and bridging processes.…”

“…In addressing these barriers to move toward socially just and therapeutically meaningful practice, Hardy (2019) states that “conducting progressive conversations about race and possessing the ability to effectively address thorny racial issues require will and skill .” Therefore, it is critical for therapists to not only recognize sociocultural–political contexts that impact clients’ presenting concerns but also to demonstrate a will to converse and address multiple intersectional similarities and differences and the workings of power within the therapy dyad and process (Day-Vines et al, 2018; Hardy, 2019; King, 2021). In a previous article, we examined the barriers that influence therapists’ will to change and proposed a model of broaching and bridging in cross-cultural psychotherapy (Lee et al, in press). In this article, we build on our previous conceptualization and explore microskills of broaching and bridging in cross-cultural psychotherapy.…”

“…Acknowledging and addressing cultural factors and differences in therapy (i.e., broaching) have been examined as critical components of cultural competence (Choi et al, 2015), and identified as enhancing therapists’ credibility and effectiveness, as well as clients’ depth of disclosure, satisfaction with therapy, and willingness to return to future therapy (Day-Vines et al, 2018; Hare, 2015). Broaching refers to the therapist’s deliberate and intentional efforts to explicitly discuss and address various cultural aspects and systemic oppressions in the client’s life-in-contexts, cross-cultural differences in the therapy dyad, and their impacts on the therapy relationship and process (Lee et al, in press; Day-Vines et al, 2018; King, 2021). Broaching has been understood as “a whole stance or ways of approaching injustice in the world” (King, 2021, p. 88) and “ a process by which counselors can bring cultural characteristics of the client and the counselor into the room and invite clients to explore the relevance of those characteristics” (Jones & Welfare, 2017, p. 49).…”

“…It is also “a flexible, contextual intervention ” (King & Summers, 2020, p. 218) and “a multifaceted skill that can be used at multiple points” in therapy (King, 2021, p. 88). We previously theorized broaching as both case formulation and intervention, both therapy skills and a therapy stance, and both a therapy process and indicator of competent professional practice and cultural competence/humility (Lee et al, in press). Also, beyond broaching, scholars underline that it is critical to consider how to move from broaching to bridging cultural similarities and differences and the workings of power between the client and therapist toward fostering alliance in cross-cultural dyads for successful therapy (Chang & Berk, 2009; Okun et al, 2017).…”