Addressing cultural topics during psychotherapy: Evidence-based do's and don'ts from an ethnic minority perspective

Broaching-i.e., a counsellor's effort to install meaningful conversations in psychotherapy concerning one's cultural identity-is a strong predictor of positive treatment outcomes and client satisfaction, especially for minority-identified clients. Despite this understanding, the broaching literature has struggled to translate broaching principles into practical recommendations for specific behaviours and skills. The current study therefore explores the effects of broaching approaches by the therapist (i.e., direct, indirect and avoidant approach) about cultural topics including ethnicity, religion, gender expression and socioeconomic status on clients' perception of (1) the multicultural orientation of the therapist and (2) the frequency of microaggressions during therapy.

These research questions were investigated in a sample of ethnic minority clients (N = 231) who followed at least one session of mental healthcare counselling during the last 12 months.

Findings show that indirect broaching is the overall most favourable approach, whilst avoidant broaching is consistently negatively associated with all therapy-related outcome measures.

The results lay the basis for practical guidelines for broaching in psychotherapy, and provide counsellors with a foundation for having cultural conversations in an effective and respectful manner.