Multiculturalism Case

The dyadic structure of the therapeutic setting that is traditional to Western psychotherapy may not be the most (or even an) effective approach to structuring the therapeutic frame; similarly, the Eurocentric emphasis on autonomy and individuation may not be helpful or relevant to all clients. (Calabrese, 2008; Galladaro, 2009; Hall, 2003;Smith, Chambers & Bratini, 2009).

For clients of more collectivistic cultures, including Native American or Eastern cultures, the emphasis is on the community and not the individual. Accordingly, members of these cultures may find it strange, frightening, or non-productive to be singled out from the group to engage in rational conversation about the individual's thoughts, feelings, and behaviors with a relative stranger. While this paradigm is the traditional Western conceptualization of how the psychotherapeutic relationship "looks," it by no means must be structured in this manner--rigid adherence to this conceptualization will ensure that some clients do not return to a second session. A client's level of collectivistic or individualistic self-conceptualization can dictate not just whether or not the Western framework of therapy will be efficacious, but how the individual views their pathology and course of treatment as well.

It is important to note that just because Evidence Based Treatments have received clinical validation in some settings, this does not mean that they are universally efficacious (Calabrese, 2008; Hwang, Myers, Abe-Kim, &Ting, 2008; ).

Far from being certified as a one-size-fits-all modality, just because a treatment has gained "evidence-based" stature does not guarantee that it is the best choice (or even a good choice) for all clients. Indeed, EBTs that have been proven to be effective with members of minority groups seem to be the exception, not the rule. Many EBTs have been normed using exclusively or disproportionately White samples, and it should not be assumed that because the treatment works on the majority culture, similar success rates with other cultures will follow. Success with one group says absolutely nothing about the likelihood of applicability to others, and the same treatment that works wonderfully for White males may be as effective, less effective, not effective at all, or even harmful, when the treatment is used with minority clients.

Stigma is a huge threat to many individuals ever seeking treatment in the first place, this can be especially in some minority cultures, where such acknowledgement of mental illness can even effect the employment and marriage opportunities of oneself and one's family.

Since some clients may face huge repercussions in terms of seeking help, many minorities wait until a problem is out of control before getting help--which clinicians should be aware may be an issue at intake (i.e., the problem must be extremely severe, or else the client wouldn't even be there in the first place). In addition, stigma should be considered when