Therapist Multicultural Orientation: Client Perceptions of Cultural Humility, LGB Identity, and the Working Alliance

Little attention has been given to how therapist cultural humility may benefit lesbian, gay, and bisexual (LGB) clients. Thus, the current study examined whether therapist cultural humility predicted stronger client-therapist working alliances in a sample of 333 LGB individuals. LGB identity centrality (IC; the extent to which a person's LGB identity is central to their overall identity) and LGB identity affirmation (IA; the extent to which an LGB person associates their sexual orientation with positive thoughts or feelings) were considered as moderators. Therapist cultural humility predicted stronger working alliances between LGB clients and their therapist; however, this association was not moderated by IC or IA. The present results suggest that LGB clients who rated their therapists as culturally humble toward their sexual orientation also reported stronger working alliances with their therapist, regardless of IC or IA. Lastly, exploratory analyses revealed that lower therapist cultural humility ratings were associated with greater sexual orientation acceptance concerns, internalized homonegativity, difficulties coming out, and sexual orientation concealment. The clinical implications of these findings are discussed. Future research should consider the benefits of therapist cultural humility for other gender and sexually diverse persons.