Observer and Client Perceptions of Therapist Multicultural Orientation in a Jail Setting

Few studies have examined cultural factors in the context of jail-based psychotherapy. Given that incarcerated populations often consist of larger proportions of racial/ethnic minoritized groups and lower socioeconomic status individuals, more culturally oriented services could improve treatment outcomes. The multicultural orientation (MCO) framework could maximize psychotherapy outcomes with this clinical population; however, previous research has not examined MCO in a jail-based treatment setting. Additionally, research has historically utilized client and therapist perspectives of therapeutic alliance and cultural processes during psychotherapy, with observer perspectives receiving minimal attention. This study contributes to existing literature on jail-based psychotherapy and therapist MCO by investigating client and observer perspectives of therapists' demonstration of cultural humility, missed cultural opportunities (i.e., a therapist's engagement in cultural discussions during session), and therapeutic alliance. Fifty-eight adult (M = 35.18 years; SD = 10.52) clients participated in this study. Participants were predominately men (84.5%) and self-identified as White (27.6%), Multiracial (24.1%), African American/Black (20.7%), or Latine/Hispanic (20.7%). Results indicated that both clients and observers indicated a stronger therapeutic alliance if they perceived the therapist as more culturally humble. Clients indicated lower alliance when they perceived the therapist to have missed more cultural opportunities during session. There was no relationship between client and observer ratings of therapist cultural humility, missed cultural opportunities, or therapeutic alliance. This study provides evidence regarding the potential utility of comparing client and observer perspectives of therapeutic alliance and cultural processes in psychotherapy, as well as contributes to the scarcity of research on psychotherapy treatment in jail settings.