This article examines the role of cultural knowledge and culture-specific techniques in the psychotherapeutic treatment of ethnic minority-group clients. Recommendations that admonish therapists to be culturally sensitive and to know the culture of the client have not been very helpful. Such recommendations often fail to specify treatment procedures and to consider within-group heterogeneity among ethnic clients. Similarly, specific techniques based on the presumed cultural values of a client are often applied regardless of their appropriateness to a particular ethnic client. It is suggested that cultural knowledge and culture-consistent strategies be linked to two basic processes—credibility and giving. Analysis of these processes can provide a meaningful method of viewing the role of culture in psychotherapy and also provides suggestions for improving psychotherapy practices, training, and research for ethnic-minority populations.

For nearly two decades research has been devoted to the investigation of the adequacy of psychotherapeutic services and treatment practices for ethnic-minority populations. Yet clinical and community psychologists continue to be perplexed by the problem of how to increase the effectiveness of mental health services to these populations. Although it can be legitimately argued that much more research is needed in order to address this problem, perhaps our efforts need to be redirected to some basic issues that have been overlooked.

This article examines the principles underlying attempts to develop effective psychotherapy with ethnic-minority groups. Several points are made. First, investigators have been remarkably consistent in offering recommendations or suggestions for improving the relationship between therapists and ethnic-minority clients. These recommendations typically involve therapists’ knowledge of culture and specific techniques based on this knowledge. Second, the suggestions raise problems for therapists. Third, in order to resolve these problems, research and practice should be redirected to two key processes involving therapist credibility and giving. Fourth, by focusing on these processes, guidelines for therapy, training, and research can be more adequately specified. Although these four points are illustrated primarily with Asian Americans in this article, they have direct relevance to other ethnic or cultural groups.