Psychotherapy and Collectivism: The Potential for Value Compatible Treatment Joe Enright
University of Saskatchewan
Dr. Michelle Presniak
Psychotherapy and Collectivism: The Potential for Value Compatible Treatment Increasing cultural diversity in the Western world has made the role of culture in the context of psychotherapy an increasingly important issue for consideration. The populations of many Western countries have growing ethnic minority segments. In Canada, up to 250, 000 new immigrants arrive each year, the vast majority from non-Western countries, including 60% from Asia (Statistics Canada, 2009). This influx of non-ethnic majority individuals has significant implications for the mental health community. This is due to the many mental health, and treatment difficulties faced by minorities, including: a greater risk of developing mental health problems, underutilization of mental health services, early disengagement and termination of therapy, poor therapy satisfaction, and less positive therapy outcomes (e.g. Plants & Sachs-Ericsson, 2004; Ayalon & Young, 2005; Markowitz, Spielman, Sullivan & Fishman, 2000). These difficulties may be at least partially attributed to the fact that the majority of the theories and interventions utilized by the field of psychotherapy, originated in Western Europe and North America (Ivey, 1993). Additionally, a strikingly small number of therapists in North America identify themselves as ethnic minorities (< 10%), creating the potential for considerable difference in cultural values between therapist and minority clients (Johnson, 2001). Cultural incompatibility of the model of therapy and/or therapist with the cultural values of the client, has been pointed to as an impediment to successful therapeutic outcomes for minorities (e.g. Terrell & Terrell, 1984; Atkinson, 1983; Constantine, 2002; Farismadan et al., 2007). Cultural competency and culturally sensitive therapies have therefore become a major issue of importance for the field of psychotherapy (Sue, Zane, Nagayama Hall & Berger, 2009). Similar cultural or ethnic background between therapist and client has shown to result in better client ratings of both therapy outcome and process (Farismadan et al., 2007). Isolating similar ethnicity or culture as the factor driving these positive results, through research, is difficult however, due to the vast diversity found within any one ethnic group. This difficulty is exacerbated by the tendency in the literature to use broad ethnic categories such as Black, Latino, Asian, etc. Furthermore, given the previously mentioned miniscule proportion of therapists from non-majority ethnic backgrounds in North America (Ivey, 1993), ethnic matching for most minorities seeking psychotherapy is not feasible. One potential alternative to ethnic-matching of therapists and clients is to focus on cultural traits common to multiple groups and the tailoring of psychotherapeutic methods to these traits. This idea is in line with the belief that focusing on similarities rather than differences between groups, may aid in culturally competent practice (Stuart, 2004). Adapting psychotherapeutic treatment based on the client’s degree of collectivism versus individualism has been looked to as one possible way to provide culturally competent therapy (Kuo, 2004; Sato, 1998). Collectivism is briefly defined as the valuing of the group over the individual, and is a trait common to multiple ethnic groups and societies (Hofstede, 1980). Collectivism has been correlated with psychological factors related to personal well-being (Oyserman, Coon & Kemmelmeier, 2002), and may also affect therapy model preference (Shilo, 1994). It is possible then that interventions addressing values and processes central to collectivism may be more effective for individuals who self-construe themselves as...