Authors: Logan Walker, Kate Coneys, Nick Tops, Russ Bailey
Mentors: Russ Bailey
Insitution: Utah Valley University
Background:
Cultural humility is an influential concept in Multicultural Orientation therapeutic research (Owen et al, 2011). Cultural humility is defined as “a lifelong process of self-reflection and self-critique whereby the individual comes to value and respect cultural diversity, recognizes his or her own biases, and is open to learning from others" (Tervalon & Murray-Garcia, 1998, p. 117). Cultural humility practices attempt to address cultural differences in therapy. Therapy absent of cultural humility can run the risk of failing the needs of culturally diverse clients. Racial and ethnic minorities are more likely to experience premature termination (Owen et al., 2015). Premature termination is defined as when a client begins an intervention but discontinues prior to recovering from the problem that he or she sought treatment for against provider recommendations (Swift & Greenberg, 2012). Premature termination is a significant concern as those who do not complete an intervention are less likely to experience symptom relief or meet their treatment goals (Steinberg et al., 2019). hope to better understand the link between cultural humility and premature termination/treatment deterioration in therapy in college students. We hypothesize that lower therapist’s cultural humility will be associated with an increased likelihood to unilaterally terminate therapy prematurely or show treatment deterioration.
Methods:
Data was collected from students who participated in therapy at the Utah Valley University Student Health Services from 2021-2023. The sample size for this dataset is approximately 560 participants.
We will use two different operationalizations of premature termination/treatment deterioration:
1. Clients who reported have attended therapy for at least 3 sessions, has at least 1 cultural humility datapoint, and reported feeling “worse than at intake” on an item of subjective progress during at the last attended session with no future sessions scheduled for at least 90 days.
2. Clients who scored worse or the same on well-being indictors (PHQ-9 and GAD-7) and reported feeling “the same as intake” or “worse as intake” on an item of subjective progress during the last attended session with no future sessions scheduled for at least 90 days..
Clients completed the Cultural Humility Scale (Hook, 2013) and microaggression items at the beginning of their 3rd session and then every 4 sessions (e.g., session 7, 11, etc.). Clients completed the PHQ-9, GAD-7, and subjective progress items at the beginning of every session. We will use logistic regression to see how cultural humility scores and microaggression frequency/impact predict premature termination/treatment deterioration.
Results:
Results from the analyses will be presented during the poster presentation
Discussion:
The results of the study will help us determine if therapist's cultural humility is related to client premature termination. If we find support for our hypothesis, this means that cultural humility is an important factor in therapeutic processes that has direct impact on the effectiveness for therapy interventions. However, rejecting our hypothesis may suggest that cultural humility is not an important aspect of premature termination. Limitations of this study include potential ceiling effects due to therapists striving to be cultural humble and thus limiting the variability in our sample.
References
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
Owen, J., Drinane, J., Tao, K. W., Adelson, J. L., Hook, J. N., Davis, D., & Fookune, N. (2015). Racial/ethnic disparities in client unilateral termination: The role of Therapists’ Cultural Comfort. Psychotherapy Research, 27(1), 102–111. https://doi.org/10.1080/10503307.2015.1078517
Steinberg, A. M., Layne, C. M., Briggs, E. C., Liang, L.-J., Brymer, M. J., Belin, T. R., Fairbank, J. A., & Pynoos, R. S. (2019). Benefits of treatment completion over premature termination: Findings from the National Child Traumatic Stress Network. Psychiatry, 82(2), 113–127. https://doi.org/10.1080/00332747.2018.1560584
Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80(4), 547–559. https://doi.org/10.1037/a0028226