Respectful, empathic engagement across differences

Notions clés

Empathy

Empathy means understanding what another person is experiencing or trying to express. Across 82 samples, therapist empathy predicted outcome (r = .28) across orientations and presenting problems; ratings by clients, observers and therapists predicted outcome better than tests of empathic accuracy.

Cultural humility

Cultural humility is an other-oriented interpersonal stance marked by respect and a lack of superiority toward a person's cultural background and experience. Clients who saw their therapist as culturally humble reported a stronger working alliance, which in turn carried its link to improvement.

Microaggressions

Racial microaggressions are brief, commonplace verbal, behavioral or environmental indignities, intentional or not, that send negative racial slights to people of color. Sue and colleagues describe microassaults, microinsults and microinvalidations and show how unnoticed ones impair the therapeutic alliance.

Cultural opportunities and comfort

The multicultural orientation framework pairs cultural humility with cultural opportunities (moments when a client's cultural identity can be explored) and cultural comfort. Early evidence links these to the alliance, perceived improvement and racial and ethnic disparities in termination.

Social class

APA's guidelines on low-income and economic marginalization ask psychologists to build self-awareness, challenge their own implicit and explicit biases about social class and poverty, and adapt interventions, noting that economic status intersects with other identities.

Exemple commenté

At intake, Dale, 50, a long-haul truck driver who left school at 15, is handed a six-page questionnaire. As the psychologist uses terms like "cognitive distortions" and proposes weekly evening sessions, Dale's answers grow short and he checks the time.

1. Read the shift as information about the exchange, not as resistance: something in how the session is running has stopped working for him.
2. Respond empathically from his side, for example: "That's a lot of paperwork and jargon at once, and I haven't asked what your schedule allows."
3. Stay humble about his circumstances: ask, rather than assume, how he prefers to handle forms, when he is home and what he hopes to get from coming.
4. Adapt: go through the remaining questions aloud if he wishes, use plain words, and set session times around his weeks on the road.

Respect shows in noticing when a setting fits the psychologist better than the client, and changing it.