A qualitative study exploring psychologists’ experiences of establishing cross-cultural therapeutic alliances.

Abstract

The therapeutic alliance has been found to be an important component for the successful outcome of psychotherapy. Much research has been dedicated to uncovering the attributes and techniques that aid in the establishment of meaningful therapeutic alliances. However, there is a lack of qualitative research focused on the influence of cross-cultural dynamics on the establishment of therapeutic alliances. Thus, this study aims to explore psychologists’ experiences of establishing cross-cultural therapeutic alliances in South Africa and to uncover the attributes and techniques that influence cross-cultural alliances through the use of an explorative, cross-sectional design. In this study, eight clinical/counselling psychologists were purposively selected via an online registry of practicing psychologists in the Durban area of Kwa-Zulu Natal. The participants were interviewed about their experiences of establishing cross-cultural therapeutic alliances through the use of open-ended, semi-structured interviews. The data was interpreted and analyzed thematically with Bordin’s (1979) Working Alliance Model as a theoretical framework in mind. The results of this study highlight that there are some limitations to this model, with cultural sensitivity not being acknowledged as an important component of the working alliance. The psychologists’ experiences of culturally different client-therapist pairings illustrate how cross-cultural dynamics (i.e., race, gender, language, age, beliefs about mental health, and worldviews) complicate the process of forming meaningful therapeutic alliances in intercultural therapeutic dyads. Cultural knowledge, interpersonal sensitivity, structural flexibility, and conscious awareness of personal/cultural biases were found to be essential when working cross-culturally. Based on these findings, this study suggests that cross-cultural experiences meaningfully influence the establishment of a therapeutic alliance in the South African context and psychologists practicing cross-culturally should continue to reflect on how the complex dynamics of culture infiltrate their therapeutic relationships.