Authors: Kate Coneys, Nick Top, Russ Bailey, Logan Walker, Julia Toomey
Mentors: Russ Bailey
Insitution: Utah Valley University
Background: Past literature has emphasized the importance of practicing culturally competent care and has shown that higher clinician cultural humility, as well as a lower frequency of microaggressions occurring in therapy, have been associated with more desirable therapeutic outcomes in retrospective, cross-sectional studies. However, research has also shown that patient outcomes appear to be unrelated to their therapist's experience level (Erekson et al., 2017), suggesting that more experience may not lead to being a more effective therapist, including more culturally humble. Despite the breadth of research on the significance of cultural competence, less is known about how a therapist's cultural humility changes across treatment with a particular client, or how a therapist’s cultural humility changes over an extended period. The aim of the current study is to examine this concept by analyzing both the relationship between the number of sessions spent working with a given therapist and a client’s rating of the clinician’s cultural humility, as well as the relationship between the average cultural humility rating of the therapist and time. We will also examine how the impact of microaggressions occurring in therapy changes during the course of therapy.
Hypotheses: It is hypothesized that the results of this study will show a positive association between the number of sessions with the same therapist and their cultural humility, as rated by the client, as well as a negative association between the number of sessions and the impact of microaggressions reported by the client. Additionally, it is hypothesized that the therapist’s cultural humility rating over the entire course of data collection will not change to a statistically significant degree.
Methods: We used archival data collected by Utah Valley University’s Student Health Services Counseling Center from August 2021 – September 2023. This archival dataset consists of 564 clients with at least one cultural humility and microaggression data point. Beginning at the third session, and occurring again every four sessions, clients were asked to rate their clinician’s cultural humility, using The Cultural Humility Scale (Hook et al., 2013), and report the frequency and impact of microaggressions that had occurred during the last four sessions. We will analyze the data using multi-level latent growth modelling.
Results: Results will be presented as part of the poster presentation.
Discussion: If the results of this study agree with the hypothesis, the implications may be that cultural humility improves over time with specific clients, potentially explained by growth of therapeutic alliance over time. However, it may also imply that a therapist’s cultural humility does not improve over extended time periods, showing that cultural humility appears to be static rather than dynamic. If the results do not agree with the hypothesis, this may imply that a client’s perception of their therapist’s cultural humility is static, but that over extended periods of time a therapist’s cultural humility can improve, implying that it is trainable.
Sources:
Erekson, D.M., Janis, R., Bailey, R.J., Cattani, K., Pedersen, T.R. (2017). A longitudinal investigation of the impact of psychotherapist training: Does training improve client outcomes? Journal of Counseling Psychology, 64(5), 514-524. https://doi.org/10.1037/cou0000252
Hook, J.N., Davis, D.E., Owen, J., Worthington, E.L., Utsey, S.O. (2013). Cultural humility: measuring openness to culturally diverse clients. Journal of Counseling Psychology, 60(3), 353-366. https://doi.org/10.1037/a0032595