Multicultural Therapy

People from all walks of life and diverse backgrounds can experience difficulties leading them to seek help through therapy. However, it is generally acknowledged that some traditional forms of therapy may not be as effective at addressing the concerns of minority groups in our society.

Enter multicultural therapy, which aims to effectively treat people from different cultural backgrounds.

What is multicultural therapy?

In a multicultural approach, a therapist works with you to understand the difficulties you are experiencing from the unique perspective of your culture. The therapist takes into account the mediating role of cultural factors in helping you to address mental health problems or challenging life events.

There is no single, prescriptive way that multicultural therapy is structured. Rather, it refers to a theoretical difference in approach which can be applied to many different types of therapy. This includes Cognitive Behavioral Therapy, Couples Counseling, and Psychoanalysis, to name just a few therapy types. The important difference is that your therapist adopts an approach that is sensitive to cultural diversity.

Multicultural therapy takes into account many forms of diversity, including:

  • Racial
  • Ethnic
  • Sexual
  • Spiritual
  • Socioeconomic background
  • Disability

Matters of race or culture can impact on our psychological wellbeing in a negative way. For example, people subjected to racism or discrimination may experience mental health problems like depression or anxiety. However, this is not always the case.

Therapists who work in a multicultural framework acknowledge that matters of race and cultural identity can have a powerful impact on our mental health in both positive and negative ways.

What can multicultural therapy help with?

If you identify with being a member of a minority group or different cultural background, it’s likely that you’ll benefit from therapy in a multicultural framework. You could be seeking therapy for any number of reasons where cultural factors are involved, including challenging life situations and mental health problems.

People may benefit from multicultural therapy if they are struggling to cope with:

  • Racism or discrimination: The adverse ways society reacts to people because of cultural factors, like a difference in appearance or the way a person talks or behaves.
  • Cultural identity: People may experience difficulties trying to balance their sense of cultural identity with that expected of them in the culture in which they currently live.
  • Difficulty acculturating: For example, people who have immigrated to another country may experience difficulties adjusting to cultural differences in their new environment.

The kinds of experiences described above can lead to distress or mental health problems such as depression or anxiety. In such cases, mental health problems can be treated more effectively with a culturally sensitive approach to therapy.

Effectiveness of multicultural therapy

A culturally competent practice is considered by mental health professionals to be a critically important aspect of effective therapy. [1] It enables you and your therapist to develop a shared understanding of your experience and develop a strong relationship – and research shows us that this strong relationship directly influences how effective therapy is.

How does multicultural therapy work?

There are three elements to effective multicultural therapy, according to experienced multicultural psychologist, Dr Melba Vasquez. These are:

  1. Cultural sensitivity: Your therapist is culturally sensitive and appreciates cultural diversity. This means that you and your therapist can look at your experience and the world from a shared culturally specific viewpoint. This enables you develop shared goals for therapy.
  2. Cultural knowledge: Your therapist will be aware of how cultural factors can influence your psychological wellbeing. For example, in some cultures, it is considered a very normal and adaptive part of the grieving process for family members to experience visions or voices of their deceased loved ones. If not viewed from a multicultural perspective, this could be mistakenly identified as a symptom of a different mental health problem.
  3. Cultural empathy: Your therapist understands your cultural perspective and can connect with you and build a strong, trusting, working relationship based on this foundation.

Frequency and length of multicultural therapy sessions

A multicultural approach can be applied to many different therapy types. As such, the frequency and length of multicultural therapy sessions can vary according to the type of therapy you are participating in. For example:

  • Cognitive Behavior Therapy (CBT): CBT is a shorter-term type of therapy. Initially, sessions tend to be weekly. They become less frequent as you gain and practice skills as therapy progresses.
  • Psychodynamic therapy: Sessions tend to be more regular in psychodynamic therapy and may continue over the longer-term, for months or years.

Structure of multicultural therapy sessions

Because multicultural therapy does not refer to a particular type of therapy, you and your therapist will decide which kind of therapy is most appropriate for you. This will influence the structure of sessions.

That said, there are phases common to the structure of most types of therapy, as follows:

  1. The initial session is likely to involve your therapist asking you questions. This helps your therapist to gain an understanding of your concerns and the kinds of difficulties you are experiencing. They may ask you to complete questionnaires or other assessments.
  2. There is a strong emphasis on developing a trusting relationship between you and your therapist at this time.
  3. You and your therapist will agree on and set goals and a way of measuring your progress.
  4. Although it depends on the type of therapy you are participating in, the bulk of sessions are likely to focus on problem-solving and skills training. Your therapist might ask you to complete homework in between sessions.
  5. As you review and measure your progress towards the end of therapy, you are likely to work with your therapist on an action plan to help prepare you to cope with future challenges.

What happens in a typical multicultural therapy session?

What happens in a multicultural therapy session depends very much on your cultural background, as well as the type of therapy you are working in. The important thing is that the therapist is adjusting their approach and the structure of therapy in a culturally sensitive way.

Some examples of situations in which multicultural adaptations might be made to a therapy session follow:

  • In some types of therapy, like CBT, the therapist asks a lot of direct questions. In some cultures, it is considered inappropriate to do so, and the relationship between the therapist and client may be damaged if such an approach was taken. In a multicultural therapy approach, the therapist will be aware of this potential and may avoid this aspect of CBT. They will adapt their approach to work with you in other more culturally appropriate ways.
  • Usually, therapists take a collaborative approach to your relationship, so that you are working together as equals. In some cultures, people may find that they lose confidence in their therapist if such an approach is taken, as they expect a more authoritative approach to treatment.

What to look for in a multicultural therapist

  • Look for a licensed mental health professional who has participated in cultural awareness training and has prior experience in multicultural therapy. Many therapists have a particular interest in working in this area. They will often include this in their biographies so that it’s easy for you to find when searching for a therapist.
  • It’s important to find a therapist with whom you feel comfortable working. The trusting working relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. Look for a therapist who communicates an understanding of, and is sensitive to, the cultural issues relevant to you.
  • The best way to gauge how you might feel about your prospective therapist is to ask for a preliminary phone call. Most therapists will be happy to oblige. This gives you the opportunity to ask about:
  • Their qualifications
  • Their experience working in multicultural therapy
  • Any ongoing cultural competency training they are undertaking
  • What therapy with them will be like