A Phenomenological Exploration Into Therapists' Multicultural Case Conceptualizations

• Published in: Journal of psychotherapy integration 2023-09, Vol.33 (3), p.302-320
• Main Authors: Hereford, McKenna, Wilcox, Melanie M., Pollard, Elinita
• Format: Article
• Language: English
• Subjects: Case Conceptualization; Competence; Counseling; Cultural Competence; Diagnosis; Female; Human; Interviews; Multiculturalism; Phenomenology; Therapists
• ISSN: 1053-0479; 1573-3696
• DOI: 10.1037/int0000299

Scholars have long emphasized the importance of cultural responsiveness in therapy; however, the evidence for the multicultural competence (MCC) model is mixed, and most extant research is quantitative in nature. The purpose of this phenomenological study was to gather insight into what therapists focus on during conceptualization without prompting for multicultural information. We conducted a qualitative study to examine therapists' multicultural case conceptualization and diagnosis to better understand therapists' cultural processes. The research questions were: What do therapists attend to in case conceptualization, and how does it influence diagnosis? How do these diagnoses influence intervention? Semistructured interviews were conducted with seven White practicing psychotherapists who were asked to provide a case conceptualization in response to a vignette. Participants' interview data (inclusive of their case conceptualization and answers about their thought processes) was analyzed, and six themes emerged: MCC, systems of support, controlling images, biological factors, multicultural orientation, and focus on cognitive therapies. Implications and future directions are discussed. Public Health Significance Statement This study suggests White therapists tend to focus primarily on internal factors and neglect multicultural factors during therapy. Focusing on multicultural factors during therapy may help alleviate termination rates and increase mental health service-seeking behaviors among Black, Indigenous, and People of Color. 治疗师多元文化案例概念化的现象学探索长期以来，学者们一直强调文化反应性在治疗中的重要性;然而，多元文化能力(MCC)模型的证据是混合的，并且大多数现存的研究在本质上是定量的。这项现象学研究的目的是在没有提示多元文化信息的情况下，了解治疗师在概念化过程中关注什么。我们进行了一项质性研究，以检查治疗师的多元文化案例概念和诊断，以更好地了解治疗师的文化过程。研究问题是:治疗师在病例概念化中关注什么，它如何影响诊断?这些诊断如何影响干预?对7名白人执业心理治疗师进行了半结构式访谈，要求他们提供一个案例概念化来回应一个小片段。分析了参与者的访谈资料(包括他们的案例概念化和对他们思维过程的回答)，形成了6个主题:MCC、支持系统、控制图像、生物因素、多元文化取向和关注认知疗法。并对未来的发展方向进行了讨论。 Una exploración fenomenológica de las conceptualizaciones de casos multiculturales de los terapeutasLos académicos han enfatizado durante mucho tiempo la importancia de la sensibilidad cultural en la terapia; sin embargo, la evidencia para el modelo de competencia multicultural (MCC) es mixta, y la mayoría de las investigaciones existentes son de naturaleza cuantitativa. El propósito de este estudio fenomenológico fue recopilar información sobre en qué se centran los terapeutas durante la conceptualización sin incitar a la información multicultural. Realizamos un estudio cualitativo