Therapists’ responses to cultural ruptures: A pilot study of external ratings of multicultural orientation

In the field of counseling and clinical psychology, the last several decades have been characterized by a strengthened recognition of the importance of cultural factors in psychotherapy. While this has been impactful, there is evidence that racial/ethnic disparities in psychotherapy outcomes persist. Cultural ruptures, defined as subtle misattunements impacting the therapeutic alliance, may play a role in maintaining these outcome disparities. The present study sought to pilot a practice-oriented method for defining and measuring cultural ruptures, specifically related to race and racism. Four mock counseling videos were created depicting different types of cultural ruptures related to race. In total, 88 white counseling trainees were recruited. Participants recorded themselves responding to cultural rupture videos, and they were asked to self-rate their level of understanding and effectiveness. Coders were trained to rate participants’ levels of cultural comfort, cultural humility (CH), cultural opportunities, and overall effectiveness. Results revealed that cultural ruptures could be reliably coded and measured in this practice-oriented way. Secondly, results suggested that white therapists tend to overestimate their effectiveness in responding to cultural ruptures in comparison to coders. Implications, limitations, and future directions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)