Identity Salience: An Intersectional Approach to Understanding Multicultural Processes and Outcomes in Psychotherapy.

A growing body of research has demonstrated the importance of therapists' multicultural orientation (MCO), namely, their cultural humility (CH), cultural comfort, and cultural missed opportunities, on treatment processes and outcomes (Davis et al., 2018). However, to date, few research has attempted to identify client factors that may moderate the relationship between therapists' MCO and therapeutic processes and outcomes. Informed by Yakushko et al.'s (2009) identity salience model, this study seeks to advance the MCO literature by examining the saliency of clients' cultural identities, therapists' MCO, and improvement in therapy. Data for this study consisted of 193 individuals who had received at least five sessions of psychotherapy in the last 6 months and responded to an online survey about their experience in therapy. Moderated polynomial regression and response surface analysis was used to examine if the relationship between therapists' MCO and clients' perceived improvement in psychotherapy differed as a function of the salience of clients' first and second most important cultural identities. The results indicated that when clients report only one highly salient cultural identity and perceive their therapist high in cultural humility, they report high levels of improvement. In contrast, when clients reported two highly salient identities, cultural humility and improvement in therapy were not significantly related. Public Significance Statement: This study examines how improvement in therapy is related to therapist multicultural orientation with clients that report two cultural identities (i.e., race, gender, religion, etc.) that vary in saliency. The results indicated that improvement in therapy was high for clients who report one highly salient identity and perceive their therapist to be high in cultural humility. In contrast, therapist cultural humility and improvement were not significantly related in the context of clients who hold two highly salient identities. Practitioners should engage in self-reflection of their own identities, engage in discussions of cultural identity outside of therapy, and seek out opportunities to facilitate their cultural understanding of the world to assist in improving therapeutic outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Counseling Psychology is the property of American Psychological Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)