Understanding the Lived Experiences of White British and African-Caribbean Psychological Therapists: An Interpretive Phenomenological Analysis of Cross-cultural Therapeutic Work

Abstract

Background: England has a multicultural society and so, health professionals will engage with clients from culturally and racially diverse backgrounds. Research suggests that psychological therapists are not adequately prepared or trained to practice cross-culturally, even though multicultural competence is recognised as a key component of mental health policy and professional codes of conduct. In particular, research is lacking on how psychological therapists experience cross-cultural practice in an unlike racial and cultural dyad.

Study aims: The aims of the present research were to explore and understand psychological therapists’ lived experience of cross-cultural practice, and to identify the successful elements as well as the difficulties of cross-cultural therapeutic work.

Design: Seven practising psychological therapists (four White British and three African-Caribbean) were interviewed about their cross-cultural work using a semi-structured format. Their accounts were analysed using Interpretative Phenomenological Analysis (IPA).

Findings: Four themes were identified: (1) The mastering cross-cultural/racial practice; (2) barriers to effective cross-cultural/racial work; (3) cross-cultural/racial learning in practice; (4) supervision/support as a “potential” site for cross-cultural fertilisation. These four themes culminate in the overall finding that: participants felt unprepared and inadequately trained to practice cross-culturally, but over time and with ongoing training and supervision, their experiences shifted progressively to mastery of a range of culturally competent skills. The findings, while supporting previous cross-cultural therapeutic work literature, have also clarified complex and important issues regarding training and supervision.

Recommendations: Within psychological therapeutic cross-cultural work, the initial and ongoing training, learning and supervision of therapists should foster experiential learning and encourage mindful exploration of own racial biases and identity, encouraging personal and professional self-exploration at both individual and group levels. Cross-cultural reflective practice, collaborative
practice and group supervision are seen as a means to reinforce and nurture therapists’ willingness to transform and competently adapt their cross-cultural therapeutic work as required. The innovation of a Cultural Formulation and Supervision Group (CFSG) is proposed as an alternative to mitigate the challenges associated with current one-to-one models of supervision and offers an environment where professionals can willingly and safely discuss difficult situations, self-explore and learn new approaches and skills in a non-judgmental and safe environment.

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Identifiers

ORCID for Ruth Bartlett: orcid.org/0000-0002-3412-2300

ORCID for Joanne C Brown: orcid.org/0000-0002-3383-8809

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