Assessing Changes in Therapeutic Alliance between Therapist Trainees and Their Refugee Clients from a Multicultural and Process Perspective

There has been a growing body of multicultural clinical and counselling research exploring and examining ways to provide culturally-responsive therapy interventions to clients of diverse cultural backgrounds. However, currently there are no models of multicultural training and research determining how client-therapist working relationship changes or unfolds over time. Hence, in this study we examined the development of client-therapist therapeutic alliance longitudinally, within a therapeutic process, through an 8-month-long multicultural counselling practicum for clinical psychology Ph.D. trainees (N = 17) working with community-based refugee clients (N = 22). Specifically, the following data was collected: a) clients’ weekly ratings of the quality of the session; b) clients’ ratings of therapy outcome and perceived change in their lives (every third session); and c) both clients’ and therapists’ individual ratings of the quality of the therapy relationship (every third session). Results revealed that, as predicted, the ratings of therapeutic alliance by both the therapists and their refugee clients significantly improved over time. Refugee clients’ ratings for therapy outcome also significantly improved over the course of the therapy. The findings of the current study offer valuable implications for therapy intervention and relationship building with culturally diverse refugee client populations specifically and for multicultural and cross-cultural counselling training more generally.