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ABSTRACT Therapists working with couples whose cultural background is different from their own may face problems in assessment, as well as in planning couple therapy. In this paper we provide a model for assessing and treating couples when the cultural differences play an important role. The therapist must be aware of the roles and expectations within the therapist-couple relationship and be prepared to change strategies as needed. The assessment and management must include culturally and ethnically sensitive questions and appropriate interventions. The couple's relationship with other members of their kin group, family or society is likely to be vital. These issues are discussed in the context of the proposed model.
Introduction
With Britain becoming a well established multicultural society, it is increasingly common that couples seeking therapy and the therapists who see them come from different cultural backgrounds. This situation can have an impact on the expectations of the client in his/her help-seeking, as well on as those of the therapist in his/her provision of help. Issues arising from this have been discussed in some depth in the literature. For example, d'Ardenne and Mahtani (1989) have addressed the key issues surrounding what they have called `transcultural counselling'. In a wide-ranging and influential paper, d'Ardenne (1991) discussed many of the issues pertaining to therapy for couples from the ethnic minorities. More recently, Bhugra and Bhui (1998) have discussed the various parameters that need to be taken into account when practising psychotherapy with clients from ethnic minorities, with particular emphasis on the client-therapist interaction. A key factor in a satisfactory therapist-client interaction is the existence of a common goal towards which the two parties work on the basis of their understanding of the problem and the harmonious implementation of a management strategy. Mutual expectations, normally conditioned by wider cultural norms and past experiences, tend to play a key role here. This role of mutual expectations is illustrated in Fig. 1, which depicts the therapeutic encounter.
It can be argued that psychotherapy, or indeed therapy of any kind, is culture-specific. The therapies widely used in the British setting are also, for historical reasons, Eurocentric (cf. d'Ardenne, 1991). However, within each mode of psychotherapy, there exist key elements which can be classed as universal. These are the...