The utility of a narrative approach to establish therapeutic alliance in a cross-cultural setting

Abstract

When therapists engage with clients from a culture other than their own, narrative therapy can be applied to overcome the linguistic and cultural challenges that result. Accordingly, this type of therapy allows for collective interactional problem solving. Hence, a qualitative narrative approach to therapy is advocated as being more culturally sensitive in diverse settings, because it should enable therapists to determine their clients' worldviews. This is a critical aspect of cross-cultural assessment and intervention when establishing an effective therapeutic relationship. The purpose of this study was to explore and describe (Babbie&Mouton, 2001) the utility of narrative therapy in order to enable a therapeutic alliance in a cross-cultural psychological assessment and intervention in a remote school. For this purpose, a qualitative research approach was adopted together with a constructivist paradigm. In addition, a content analysis design was employed by analysing existing documents comprising field notes (those of the student therapist, the supervisor and two peer supervisors), a reflection journal and visual data generated during cross-cultural psychological assessment and intervention sessions at the school. After reviewing the relevant literature, a priori categories (deductive analysis) were identified and the data sources were searched for instances of therapeutic alliance. This study found that the therapist's counselling skills and, more specifically, displaying coordinated acts of concern to benefit the client, namely actions such as thorough planning with a rationale for change; clear, logical communication; giving opportunities for re-learning; giving time; cooperation; being involved (responsive and taking part); paying attention (awareness and insight); benevolence; giving advice; being respectful; and instilling/communicating a sense of hope, may prove to have potential value in establishing a therapeutic alliance with these clients. In addition, the study found that the use of a narrative therapy technique, the clients, positive affect and the interaction between the therapist and the clients (therapeutic relationship) contributed marginally to the established alliance. The findings of the study suggest, therefore, that cultural competence did not contribute meaningfully to the development of a therapeutic alliance in this specific case, as cultural competence skills were not observed in the actions of the therapist. The findings further suggest that common factors, such as those of the therapist, client, relationship, and technique, are interactive and dynamic, and are all necessary factors in establishing a therapeutic alliance in cross-cultural assessment and intervention at a remote school. Copyright