Jim, Jenny; (2003) Chinese cultural values in therapy: Perspectives from clients and therapists. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Chinese people are rarely seen in mainstream NHS mental health services and have been described as an 'invisible population' (DoH, 1994). Initial obstacles to accessing therapeutic services may be a result of a lack of awareness of services, language barriers, lack of availability of routine interpreting services, as well as perceptions of psychological help-seeking as a relatively modern and novel means of resolving mental health issues. There is evidence that those who do seek help, tend to disengage prematurely. Much has been written on the cultural differences between western and eastern values and belief systems but little exists on actually how these may affect the success or failure of the process of therapy. Furthermore, there is a dearth of literature on how to provide more 'culturally responsive' therapeutic treatments. This study aimed to provide an exploration into the experiences of therapy or counselling of a small number of Chinese people living in London. It also tried to see what a small number of therapists experienced in working with this client group considered to be of importance in their clinical practice. Eight client participants and five therapists were interviewed. A semi-structured interview schedule was devised for each group. The client participants were asked about their process of help-seeking and their specific ideas of what was helpful or unhelpful about their therapy experience. The therapist participants were asked their views on what was important when working with Chinese clients. Responses for both groups were then organised into domains using themes derived from a process of qualitative thematic analysis. Client participant accounts were marked by an open and curious approach to therapy, and a sense of ownership of both the problem and the outcome of therapy. There were also contradictory findings, with some client participants feeling that the success of therapy was inextricably linked to having seen a Chinese therapist; others conveyed a feeling of being 'freed' by seeing a non-Chinese therapist; and lastly, there were those who felt that whether their therapist was Chinese or not had no relevance to their experience at all. Client participant accounts also seemed to indicate a potential difference between Chinese and non-Chinese clients in terms of the way that they viewed the role of the therapist. Therapist participant accounts were marked by a sense of fulfilling multiple roles in helping Chinese clients. They were also largely unaware of how they implicitly and skillfully integrated their knowledge of Chinese values in their clinical work. The therapist participant accounts conveyed a tension between paying due attention to the importance of Chinese cultural values, whilst also needing to recognise diversity and individuality within Chinese clients. Findings are discussed in terms of the implications for therapists working with Chinese clients and with regards to conceptual ideas relevant to service planning and delivery.

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