All psychotherapies offer hope, and nearly all psychotherapists attempt to enhance their clients’ sensitivity, openness, personal responsibility, and sense of purpose (Jensen & Bergin, 1988). But in matters of culture and values, psychotherapists differ from one another and may differ from their clients (Delaney et al., 2007; Kelly, 1990).
These differences can create a mismatch when a therapist from one culture interacts with a client from another. In North America, Europe, and Australia, for example, most psychotherapists reflect their culture’s individualism, which often gives priority to personal desires and identity. Clients with a collectivist perspective, as with many from Asian cultures, may assume people will be more mindful of social and family responsibilities, harmony, and group goals. These clients may have trouble relating to therapies that require them to think only of their own well-being (Markus & Kitayama, 1991).
Cultural differences help explain some groups’ reluctance to use mental health services. People living in “cultures of honor” prize being strong and tough. They may feel that seeking mental health care is an admission of weakness rather than an opportunity for growth (Brown et al., 2014). And some minority groups tend to be both reluctant to seek therapy and quick to leave it (Chen et al., 2009; Sue et al., 2009). In one experiment, Asian-American clients matched with counselors who shared their cultural values (rather than mismatched with those who did not) perceived more counselor empathy and felt a stronger alliance with the counselor (Kim et al., 2005).
Client-psychotherapist mismatches may also stem from religious values. Highly religious people may prefer and benefit from religiously similar therapists, and may have trouble forming an emotional bond with one who does not share their values (Masters, 2010; Pearce et al., 2015).