Cross-cultural  connections

Cross-cultural connections

Personal and cultural differences should always be considered in any therapeutic intervention

By Patti Carmalt-Vener 05/10/2012

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Dear Patti,
My sister, Lina, and I are Hispanic-Americans in our 40s who were both born in the US. Our older sister, Rosa, came here 15 years ago. Although she’s not an American citizen, she’s extremely proficient in English. We’re concerned, because she is very depressed and we think she needs to see a therapist.     

I saw a great therapist in the past in whom I have a lot of confidence. I also have a dear lady friend who has been to a female counselor, and I would feel comfortable recommending her if Rosa prefers to see a woman. Although I believe either of these psychotherapists could help Rosa with her depression, Lina disagrees.

Since they are both white and not of the Hispanic culture, Lina doesn’t think they’d be able to understand Rosa on an ethnic and cultural level, nor does she think Rosa would really open up to either of them.

While I understand this issue could be a concern, I think it’s more important to obtain a skilled and competent therapist. In my experience, they are few and far between. I’ve been to several therapists who listened and were warm but did very little to help my emotional problems. I also have friends who have had similarly unfulfilling encounters.

I would love to have Rosa see a Hispanic therapist, but I want this person to be capable, knowledgeable and, hopefully, a referral from someone we know. I don’t want the person chosen online just because that person is Hispanic. Rosa has never been to therapy before, is uncertain how to choose a therapist and is leaving it up to us siblings. What is your opinion?
 — Miguel

Dear Miguel,
I agree with you that a knowledgeable and proficient psychotherapist professionally trained in treating depression is crucial and the first concern. In this situation, however, the counselor should be of the Hispanic culture or have professional training in cross-cultural counseling. Many professional therapists do. It’s now understood that an appropriate locus of therapeutic intervention takes into account cultural as well as personal differences. If the therapist is of the present dominant culture, it’s important s/he is aware that the counseling involves the norms and values of two cultures — that of the therapist and that of the patient. 

In addition, some of the values implicit in the various therapeutic modalities that influence the counseling field may conflict with the values of the patient. An example of this is silence. An unaware therapist might mistakenly assume that silence represents avoidance or defensiveness, while many times Hispanics are silent as a sign of respect for elders or authority figures.

Choosing the right therapist is an important and essential decision. Sometimes, people will spend countless hours shopping for exactly the right pair of shoes, the perfect job or the ideal house but will often accept the very first therapist that comes along. A therapeutic relationship is a special one in which Rosa will be working together closely to explore and resolve her emotional issues. Because successful outcomes are predicated on trust and rapport — as well as the professional ability of the psychotherapist — this decision should never be rushed.

I’d suggest you select three to five counselors for Rosa to interview in person or by phone. There are many psychotherapists (myself included) who encourage first-time patients to come for a free consultation. This 20-to 30-minute meeting isn’t a psychotherapy session. Rather, it’s a chance to ask general questions about therapy, discern the therapist’s treatment approach and get a sense of what it would be like to work together. The therapist then makes recommendations about what s/he believes would be best for the prospective patient.

After interviewing each therapist, Rosa can gauge her comfort level and reaction to their personal qualities (i.e., age, gender, cultural background, credentials) and see if they “fit” her. Encourage her to trust her instincts on whether the therapist seems to understand her problems and have the ability to help her.

If she finds the right person with whom she can be honest with her feelings, it’s likely she’ll have a tremendously valuable experience, her depression will most likely lift and, over time, your sister will experience significant life changes.

Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at (626) 584-8582 or email Visit her Web site,


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