A Phenomenological Analysis of the White Therapist and American Indian Client Dyad: Common Factors, Cultural Competence, Cultural Humility, and Microaggressions

Abstract

American Indians are a highly heterogeneous group composed of over 561 federally recognized tribes. However, American Indians are underrepresented in the healthcare workforce, including psychology and mental health services. Health statistics indicate that depression, alcoholism, and suicide occur with high frequency in many American Indian communities. Due to the lack of American Indian therapists, many American Indians turn to therapists who do not always have a clear understanding of their values and beliefs. This leads one to wonder what the therapeutic experience is like for American Indian clients seeking mental health services from White therapists. This study used qualitative methodology, specifically, phenomenological methods, to understand the lived experiences of American Indian clients who attended therapy with White therapists. Results revealed several themes, including: feeling misunderstood by their therapist, confusion of racial/ethnic differences and traditional spiritual practices, discussion of or lack of discussion of racial and ethnic differences, desire to work with American Indian or other ethnic minority therapists, and cultural competence and cultural humility. Implications for clinical practice and future directions of research are addressed. More research in this area is clearly needed