Cross-cultural dialogue and its impact on the alliance in cross-cultural psychotherapy process

Four white therapists and six clients of color participated in the study. Conversation Analysis and Structural Analysis of Social Behavior were used to conduct a fine-grained analysis of how the client and therapist talked about cultural materials in actual therapy sessions, and to investigate how this discussion process influenced the alliance.;Findings show that the therapists' cultural competence in dialogue was associated with the presence of the sociocultural content discussed in therapy; the moments of integration between clinical and cultural issues provided a window of opportunity to access the clients' culturally-embedded internal world view; and the therapists' moment-to-moment interactions during cross-cultural dialogue were associated with the Bond subscale of Working Alliance Inventory-S-R. Re-visioning the construct of cultural competence in terms of relational and dynamic perspectives, the study promotes cross-cultural investigations that are clinically grounded. Several practice guidelines are provided for ongoing moment-to-moment interactional training for cultural competence in cross-cultural psychotherapy.