Assessing therapeutic communication in the treatment of Indian immigrants

This study examined the therapeutic communication between patients who are Indian immigrants and their American therapists. Verbatim transcripts of thirty sessions from thirty different patients were analyzed. Four patient measures were applied: the Global Assessment Scale, the Spousal Conflict Scale, the Generational Conflict Scale, and the Patient Educating the Therapist Scale. Three therapists' measures were applied: the Comparative Psychotherapy Process Scale, the Cultural Sensitivity Scale and the Therapist Acknowledgment Scale.; The purpose of this study was to assess how the therapist's cultural sensitivity is effected by and effects patient communication. There were four hypotheses. (1) It was predicted that the more culturally insensitive the therapist's intervention, the more likely is the patient to educate the therapist about his/her cultural background. (2) It was predicted that the greater the expressed spousal conflicts of the patient, the more likely it is to evoke an insensitive intervention from the therapist. (3) It was predicted that the greater the expressed generational conflicts of the patient, the more insensitive the intervention from the therapist. (4) It was predicted that segments in which the patient educates the therapist are more likely to be followed by therapist interventions that fail to acknowledge the patients' educational comment than by therapist interventions that acknowledge educational comment. All four hypotheses were confirmed. The results suggest an interaction structure in which expressed spousal or generational conflict evokes a culturally insensitive response from the therapist. That insensitive response evokes an educational comment from the patient that the therapist usually ignores. There was little evidence of therapists directly addressing ruptures in the therapeutic relationship precipitated by the therapists' cultural insensitivity.