Identity salience: An intersectional approach to understanding multicultural processes and outcomes in psychotherapy.

Abstract

A growing body of research has demonstrated the importance of therapists’ multicultural orientation (MCO), namely, their cultural humility (CH), cultural comfort, and cultural missed opportunities, on treatment processes and outcomes (Davis et al., 2018). However, to date, few research has attempted to identify client factors that may moderate the relationship between therapists’ MCO and therapeutic processes and outcomes. Informed by Yakushko et al.’s (2009) identity salience model, this study seeks to advance the MCO literature by examining the saliency of clients’ cultural identities, therapists’ MCO, and improvement in therapy. Data for this study consisted of 193 individuals who had received at least five sessions of psychotherapy in the last 6 months and responded to an online survey about their experience in therapy. Moderated polynomial regression and response surface analysis was used to examine if the relationship between therapists’ MCO and clients’ perceived improvement in psychotherapy differed as a function of the salience of clients’ first and second most important cultural identities. The results indicated that when clients report only one highly salient cultural identity and perceive their therapist high in cultural humility, they report high levels of improvement. In contrast, when clients reported two highly salient identities, cultural humility and improvement in therapy were not significantly related.

Observer and client perceptions of therapist multicultural orientation in a jail setting.

“…Additionally, emerging research suggests that identity saliency (see Yakushko et al, 2009) may influence clients’ perception of therapists’ cultural humility and during session (Anders et al, 2021) or even weaken the positive relationship between cultural humility and outcomes (Anders & Kivlighan, 2023). Therefore, another possible explanation for this observed difference between clients and observers could be that clients are more aware about which unique aspects of their identity are most salient to them.…”

LGBTQ+ cultural‐competence training effectiveness: Mental health organization and therapist survey outcome results from a pilot randomized controlled trial

“…Regarding their topical content, LGBTQ+ competence trainings for therapists are ever evolving and typically address use of affirming language, reflection on personal bias and prejudice and how it may impact practice, and the influence of minority stress and sociocultural context on LGBTQ+ mental health (Boroughs et al, 2015;Rossi & Lopez, 2017). More attention has been given recently to how systems of oppression across multiple, intersecting marginalized identities can undermine mental health (Anders & Kivlighan, 2023;Arora et al, 2022). While sexual health conversations are considered integral to overall therapist competency with clients, past LGBTQ+ competency trainings typically do not address this topical area (Dermer & Bachenberg, 2015;Russell, 2012).…”