STRATEGIES USED BY FOREIGN-BORN FAMILY
THERAPISTS TO CONNECT ACROSS CULTURAL
DIFFERENCES: A THEMATIC ANALYSIS
Alba Ni ~ no
Alliant International University
Karni Kissil
Private Practice
Maureen P. Davey
Drexel University
With the growing diversity in the United States among both clinicians and clients, many
therapeutic encounters are cross-cultural, requiring providers to connect across cultural
differences. Foreign-born therapists have many areas of differences to work through. Thus,
exploring how foreign-born family therapists in the United States connect to their clients can
uncover helpful strategies that all therapists can use to establish stronger cross-cultural ther-
apeutic connections. A thematic analysis was conducted to understand strategies 13 foreign-
born therapists used during therapeutic encounters. Four themes were identified: making
therapy a human-to-human connection, dealing with stereotypes, what really matters, and
flexibility. Findings suggest that developing a deep therapeutic connection using emotional
attunement and human-to-human engagement is crucial for successful cross-cultural
therapy. Clinical and training implications are provided.
Societal changes and technological advancements are altering the landscape of human rela-
tions. Now more than ever, we are exposed to individuals and groups from different backgrounds.
For example, developments in technology and transportation have facilitated more geographic
mobility, migration, and communication (Platt & Laszloffy, 2013). This is especially true for the
United States, a country that continues to have one of the highest levels of net migration in the
world (World Bank, 2014). Also, a growing awareness of social barriers such as racial and eco-
nomic discrimination is now making it possible for diverse groups that have historically remained
mutually invisible or segregated, to start seeing and relating to each other.
These global demographic trends and growing awareness are also experienced during thera-
peutic encounters between therapists and clients (Vasquez, 2007). Thus, as family therapists, we
will likely work with an increasingly diverse clientele. This will require the development of success-
ful clinical strategies that help to establish strong therapeutic relationships with clients who are cul-
turally different from us regarding culture of origin, family composition, sexual orientation,
religious affiliation, and other salient contextual variables. Providers need to learn how to connect
across cultural differences to become culturally sensitive. Even though this has been recognized
and accepted in extant literature (please see review below), studies that specifically describe
Alba Ni~ no, PhD, LCMFT, Couple and Family Therapy Program, Alliant International University; Karni Kis-
sil, PhD, LMFT, Private Practice; Maureen P. Davey, PhD, LMFT, Department of Couple and Family Therapy,
Drexel University.
We want to express our appreciation to the 13 foreign-born therapists who very generously shared their stories
of struggle and success as therapists who are clinically active in the United States. Their ingenuity, creativity and
perseverance made this paper possible.
Address correspondence to Alba Ni~ no, Couple and Family Therapy Program, Alliant International University,
10455 Pomerado Road, DH-206A, San Diego, California 92131; E-mail: anino@alliant.edu
January 2016 JOURNAL OF MARITAL AND FAMILY THERAPY 123
Journal of Marital and Family Therapy 42(1): 123–138
doi: 10.1111/jmft.12115
© 2015 American Association for Marriage and Family Therapy