Experiences of Foreign-Born Couple and Family Therapists in Building a Strong Alliance: An Interpretative Phenomenological Analysis

Couple and family therapists (CFT) are mental healthcare providers and understanding their experiences in building strong alliances with their clients would benefit the profession as the ethnic and racial demographics of clients and therapists both evolve. Specifically, previous research indicates that a weak therapeutic alliance predicts client dropout rates (Horvath, 2006), and that therapists’ competence and ability to connect with clients, instill trust and confidence, was predictive of a strong alliance (Ackerman & Hilsenroth, 2003). However, foreign-born therapists are perceived as less competent due to language barriers and internalized stereotypes against them (Ng & Smith, 2009; Peng, et al., 2022). The present Interpretative Phenomenological Analysis (Smith et al., 2021) examined the lived experiences of 12 foreign-born CFT whose first language is not English. Seven themes and 13 subthemes emerged from the data analysis of those 12 participants’ semi-structured interviews. The seven themes are as follow: (1) Strong Therapeutic Alliances, (2) Comparing Therapeutic Alliances in Individual vs. Relational Therapy, (3) Cultural Barriers, (4) Stereotypes and Assumptions, (5) Navigating Cultural Barriers, (6) Navigating Stereotypes and Assumptions, and (7) “Helping People to Expand Their Perception of Reality”. The findings support previous literature that described foreign-born CFT encounter linguistic and cultural barriers when living and practicing in the U.S. Participants employed various strategies to overcome those barriers, focusing on establishing personal connections with clients, maintaining a non-judgmental attitude, avoiding assumptions, and fostering self-confidence.