Abstract
To provide effective psychotherapy in cross-cultural situations, cultural issues need to be adequately addressed. We describe core concepts of cultural competence relevant for psychotherapists to consider. A contextualized approach to conducting cultural competent assessment and formulation is recommended, including the use of DSM-5 Outline for Cultural Formulation and Cultural Formulation Interview. We introduce a cultural competent framework to help therapists become more mindful of culturally relevant interactions in therapy. Finally, a three-tier system is proposed for the examination of psychotherapy models through a cultural lens. The concepts and framework described can be flexibly and pragmatically integrated into a therapist’s regular clinical work, increasing the therapy’s effectiveness across diverse populations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Albiero, P., & Matricardi, G. (2013). Empathy towards people of different race and ethnicity: Further empirical evidence for the Scale of Ethnocultural Empathy. International Journal of Intercultural Relations, 37, 648–655.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Aron, L., & Henik, L. (2013). Answering a Question with a Question: Contemporary Psychoanalysis and Jewish Thought. Academic Studies Press.
Aronson, H. B. (2004). Buddhist practice on Western ground: reconciling Eastern ideals and Western psychology. Boston: Shambhala.
Barrera, M., Jr., & Castro, F. G. (2006). A heuristic framework for the cultural adaptation of interventions. Clinical Psychology: Science and Practice, 13(4), 311–316.
Berry, J. W. (2003). Conceptual approaches to acculturation. In K. M. Chun, P. Balls Organista, & G. Marín (Eds.), Acculturation: Advances in theory, measurement, and applied research. (pp. 17–37). Washington, D.C.: American Psychological Association.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy, 16(3), 252–260.
Carpenter-Song, E. A., Nordquest Schwallie, M., & Longhofer, J. (2007). Cultural competence reexamined: critique and directions for the future. Psychiatric services (Washington, D.C.), 58(10), 1362–1365. doi:10.1176/appi.ps.58.10.1362.
Cohen, A. B. (2009). Many forms of culture. American Psychologist, 64(3), 194–204. doi:10.1037/a0015308.
Comas-Díaz, L., & Jacobsen, F. M. (1991). Ethnocultural transference and countertransference in the therapeutic dyad. American Journal of Orthopsychiatry, 61(3), 392–402.
Copeland, L., & Griggs, L. (1985). Going international: how to make friends and deal effectively in the global marketplace. New York: Random House.
Cortright, B. (1997). Psychotherapy and spirit: Theory and practice in transpersonal psychotherapy. Albany: State University of New York Press.
Cross, T. L., Bazron, B. J., Dennis, K. W., & Isaacs, M. R. (1989). Towards a Culturally Competent System of Care (Vol. 1). Washington, DC: National Technical Assistance Center for Children’s Mental Health, Georgetown University Child Development Center.
Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44(1), 113.
Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (Eds.). (2010). The heart and soul of change: Delivering what works in therapy (2nd ed.). Washington, D.C.: American Psychological Association.
Fernando, S. (2011). A “global” mental health program or markets for Big Pharma? Open Mind, 168, 22.
Frank, J. D., & Frank, J. B. (1991). Persuasion and healing: a comparative study of psychotherapy. Baltimore: Johns Hopkins University Press.
Fung, K. P. (2012). Psychological Acculturation. In S. Loue & M. Sajatovic (Eds.), Encyclopedia of Immigrant Health (pp. 1233–1234). New York: Springer.
Fung, K. (2015). Acceptance and Commitment Therapy: Western adoption of Buddhist tenets? Transcultural Psychiatry, 52(4), 561–576.
Fung, K., & Dennis, C.-L. (2010). Postpartum depression among immigrant women. Current Opinion in Psychiatry, 23(4), 342–348.
Fung, K. P., & Lo, T. (2012). Culturally Competent Practice and Management of Mental Health in Primary Care. In A. Khenti, J. C. Sapag, S. Mohamoud, & A. V. Ravindran (Eds.), Collaborative Mental Health. Toronto: Centre for Addiction and Mental Health.
Fung, K. P., & Wong, J. (2014). ACT to Reduce Stigma of Mental Illness: A Group Intervention Training Manual on Acceptance and Commitment Therapy. Unpublished Manuscript.
Fung, K., Andermann, L., Zaretsky, A., & Lo, H. T. (2008). An integrative approach to cultural competence in the psychiatric curriculum. Academic Psychiatry, 32(4), 272–282.
Fung, K., Lo, H. T., Srivastava, R., & Andermann, L. (2012). Organizational cultural competence consultation to a mental health institution. Transcultural Psychiatry, 49(2), 165–184.
Hall, E. T. (1976). Beyond culture. Garden City, NY: Anchor Press.
Hamilton, S., Moor Crane, D. R., & Payne, S. (2010). Psychotherapy dropouts: Differences by modality, license, and DSM-IV diagnosis. Journal of Marital and Family Therapy, 37(3), 333–343.
Hayes, S. C. (2014, November 18). Kissing the Banana Trunk: Will You Commit and Act in the Fight Against Ebola? huffingtonpost.com. http://www.huffingtonpost.com/steven-c-hayes-phd/kissing-the-banana-trunk-_b_5839680.html. Accessed December 2015.
Kirmayer, L. J. (2012). Rethinking cultural competence. Transcultural Psychiatry, 49(2), 149–164.
Kirmayer, L. J., Fung, K., Rousseau, C., Lo, H. T., Menzies, P., Guzder, J., et al. (2012). Guidelines for Training in Cultural Psychiatry. Canadian Journal of Psychiatry, 57(3), S1.
Koenig, H. G. (1998). Handbook of Religion and Mental Health. London: Elsevier.
Langman, P. F. (1997). White culture, jewish culture, and the origins of psychotherapy. Psychotherapy: Theory, research, practice. Training, 34(2), 207–218.
Lau, A. S. (2006). Making the case for selective and directed cultural adaptations of evidence-based treatments: examples from parent training. Clinical Psychology, 13(4), 295–310.
Lo, H. T., & Fung, K. P. (2003). Culturally competent psychotherapy. Canadian Journal of Psychiatry, 48(3), 161–170.
Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98(2), 224–253. doi:10.1037/0033-295X.98.2.224.
Mitchell, S. A. (1995). Freud and Beyond. New York: Basic Books.
Naeem, F., Gobbi, M., Ayub, M., & Kingdon, D. (2010). Psychologists experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan. International journal of mental health systems, 4(1), 2. doi:10.1186/1752-4458-4-2.
Polaschek, N. R. N. (1998). Cultural safety: a new concept in nursing people of different ethnicities. Journal of Advanced Nursing, 27(3), 452–457. doi:10.1046/j.1365-2648.1998.00547.x.
Qureshi, A. (2005). Dialogical relationship and cultural imagination: A hermeneutic approach to intercultural psychotherapy. American Journal of Psychotherapy, 59(2), 119–135.
Rathod, S., Phiri, P., Harris, S., Underwood, C., Thagadur, M., Padmanabi, U., et al. (2013). Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: A randomised controlled trial. Schizophrenia Research, 143(2–3), 319–326.
Reisner, A. D. (2005). The Common Factors, Empirically Validated Treatments, and Recovery Models of Therapeutic Change. The Psychological Record, 55, 377–399.
Sue, D. W., & Sue, D. (1999). Counseling the Culturally Diverse (3rd ed.). New York: John Wiley & Sons.
Tan, S.-Y. (2007). Use of prayer and scripture in cognitive-behavioral therapy. Journal of Psychology and Christianity, 26(2), 101–111.
Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125.
Tickle-Degnen, L., & Rosenthal, R. (1987). Group rapport and nonverbal behavior. In C. Hendrick (Ed.), Review of Personality and Social Psychology (Vol. 9, pp. 113–136). Thousand Oaks, CA: Sage Publications.
Tseng, W.-S. (2001). Handbook of cultural psychiatry. San Diego, CA: Academic Press.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fung, K., Lo, T. An Integrative Clinical Approach to Cultural Competent Psychotherapy. J Contemp Psychother 47, 65–73 (2017). https://doi.org/10.1007/s10879-016-9341-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10879-016-9341-8