CULTURAL ATTUNEMENT IN THERAPY WITH MEXICAN-HERITAGE COUPLES: A GROUNDED THEORY ANALYSIS OF CLIENT AND THERAPIST EXPERIENCE Marco A. Elias-Juarez Loma Linda University Carmen Knudson-Martin Lewis & Clark College There is a need for culturally attuned approaches for couple therapy with Mexican/Mexi- can-Americans. This qualitative grounded theory study utilized interviews with 11 client cou- ples of Mexican heritage and 14 marital and family therapists to shed light on how Latino and non-Latino therapists co-construct positive experiences of cultural attunement with Mexican and Mexican-American couple clients. Analysis identified a model of cultural con- nection through personal engagement with four interrelated phases: (a) mutual invitation, (b) shared engagement, (c) expanding personal connection, and (d) creating cultural con- nections. Clients in this study valued professionalism and expertise of the therapist, but felt attuned to and respected when therapists demonstrated humility, shared personal stories and emotion, and engaged in a collaborative process. Therapy is always a cultural process (Monk, Winslade, & Sinclair, 2008), yet most therapy approaches are developed within the values of the dominant culture (Parra-Cardona, C odova, Holtrop, Escobar-Chew, & Horsford, 2009). Practicing from a multicultural perspective requires development of mutually respectful relationships (Gallardo, 2014) and “being able to hear of voices of socially devalued groups in our society” (Sue, 2014, p. 267). Despite the growing popula- tion in the Unites States of persons with Mexican heritage, they are among the many whose voices have been systemically excluded and under represented in the clinical literature (Parra-Cardona et al., 2009; Taylor, Gambourg, Rivera, & Laureano, 2006). There is a need for services that go beyond “adaptation” to create a bicultural encounter “at- tuned by the most informative, nuanced and respectful way possible by asking consumers about what aspects of culture and context matters to them” (Falicov, 2009; p. 305). Nearly all the theory on cultural attunement addresses therapists’ skills and competencies. It is based on individual clientele and does not include the experiences of the clients themselves (e.g., Hook, Davis, Owen, Worthington, & Utsey, 2013; Oakes, 2011). There is little guidance regarding how to actually work with the cultural component of therapeutic relationships. In this study, we draw on interviews with Mexican and Mexican-American client couples and therapists to extend the literature on cultural attunement by focusing on what happens between them to create a positive cultural encounter. Using a social constructionist approach to grounded theory enables us to identify the therapeutic processes involved from the perspective of the participants themselves (Charmaz, 2006). Marco A. Elias-Juarez, PhD, Department of Counseling and Family Sciences, Loma Linda University Counseling Services. Carmen Knudson-Martin, PhD, Department of Counseling Pyschology, Lewis & Clark College. The authors thank Barbara Couden Hernandez, Douglas Huenergardt, and Mary Moline for their contribu- tions in developing this study. Address correspondence to Marco A. Elias-Juarez, 1241 “D” Street, San Bernardino, California 92405; E-mail: melias@ccsbriv.org JOURNAL OF MARITAL AND FAMILY THERAPY 1 Journal of Marital and Family Therapy doi: 10.1111/jmft.12183 © 2016 American Association for Marriage and Family Therapy