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Diversities in Therapy
Some clinicians don't even give it a thought about how culture or diversities may be a factor in the therapeutic relationship or even treatment success. Others are aware of it but don't know how much to consider it or even what to do about it.
So I would like to propose some possible situations/reasons that may illicit a clinician to explore diversity implications and identify different ways to respond accordingly.
One obvious one is when the diversity is clearly different, such as let's say there is a black lesbian couple working with a white male heterosexual clinician. Does the clinician note they are obviously different and inquire if they are or will be comfortable working with him; is it even necessary; could it stir up unneeded issues. After all, some may question why bring up a problem that may not even be a problem to begin with, and some would add it's not about the clinician. It would be presumptuous of the clinician to assume that the clients' would feel uncomfortable in some way because of the diversities. The thing is, therapy is very much a relationship; yes, with professional boundaries, but there is a need for the relationship to develop to promote/assure comfort and safety. And so like many relationships, we should have a sense of how we may feel about another in therapy, though it would be more about the work, which is an extension of those participating; therefore it would be valuable to be mindful and respectful of the diversities, as it helps put things in context. The key is not to get caught up in over-analyzing this, but instead, be aware of the potential implications. Some may say, feel it out and observe if there are any indications/clues of uncomfortableness or reservations. But how would you know? It's not always obvious, at least not to some, and perhaps some may misinterpret it, either way, noticing something that isn't or minimizing it alike. So, then what?
As MFTs its is known that culture and diversity is a factor to be considered, period; how much is the question. So, perhaps having some sort of acknowledgment speech of this as part of the consent for treatment discussion, when talking about therapy, client rights, therapists responsibilities, etc., noting you would like to value and respect all for who they are, being respectfully mindful of potential implications of the similarities and differences on the therapeutic alliance and work accordingly; welcoming clients to voice at any point their needs or concerns, including what they feel comfortable with or don't. Some may also share with their clients the value of exploring possible cultural, systemic, and diversity implications on what has brought them into therapy in accordance with researched best practices.
Let's take a step back and recognize that diversity is an overarching way of seeing how people are all unique individuals. Though people are unique, as in not one thing defines them, people ascribe and belong to different systems, which reflects who they are. So, naturally understanding your client's uniqueness and how those traits, standards, and beliefs affect their intrapersonal and interpersonal relationships is fundamental in understanding their emotions, behaviors, thoughts, experiences, and relationships in context, to potentially identify and change negative/dysfunctional patterns and cycles to more "healthier" ones as identified by the clients.
So going back to the original question, "Should we pay attention to diversities in therapy?" The answer I believe many would agree with is, yes, how can you not. The key would be to respectfully explore the implications diversities may have in the context of the problem, the solution, and the therapeutic relationship. Clinicians must be cautious when exploring and discussing the implications of cultures and diversities, as they are very much a part of people's identity, and you wouldn't want to offend them. Being mindful of your clients' diversities is not telling your clients there is something wrong with them, but instead, exploring and addressing diversities and cultures allows for an opportunity to get to understand the clients, their systems, and the problem/symptoms in a context, which helps promote empathy and validity.
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