Understanding Individual Therapy: Insights from a Multicultural Psychologist

Across over six decades of research, the question in therapy is what treatment, is most effective for whom, and under what conditions? This means that psychologists have been wrestling with figuring out what approaches to therapy work, what patients it works best for, and at what point in their lives. To this end, there are two areas that the field has identified as to what works with adapting therapy: 1) Identifying roadblocks to treatment; 2) Adapting therapy to worldviews.

It is a fairly commonly established idea that humans are embedded and shaped via many social contexts and situations. We are influenced, and by extension our behaviors, by things like our society, the economy, job satisfaction, marriage, lack of relationships, etc. When we look at why we do what we do a central question is to ask yourself what function does this current behavior serve? It's an odd question, especially with something like drinking or depression, to ask ourselves "What is this doing for me?" But a common step in effective therapy is to consider how we might have learned indirect ways of meeting needs or soothing. What we've learned from multicultural psychology, is that for many out there needs are not able to be met directly. One cannot afford, or doesn't have a job that allows, to take days off, so "self-care days" just aren't an option. So when we think of barriers, we should first ask what is this thing doing for me, rather than assuming it's just a problem or a defect in ourselves.

Next, we have learned that therapy works best when it makes sense and fits in with your worldview. What this means in a nutshell is that therapy explains what's going on by aligning explanations, and solutions, to how you see the world. Whether this is explaining depression through the lens of detachment from relationships, rather than just simply biological terms, or anxiety as a somatic experience that stems from your life experiences, instead of just a fight or flight response. Therapy has to make sense, it has to work to align with healthy worldviews, and it has to work to integrate research with how you make sense of the world.

In a nutshell, what we've learned from multicultural research is that we have to work to understand how people got to where they currently are and work backwards to rewrite the narrative. The same way we got to the indirect meeting of a need (e.g., family roles, society messages, those childhood experiences etc.) we have to find a way of rewriting the script to meet the needs more directly.