Multiple microaggressions and therapy outcomes: The indirect effects of cultural humility and working alliance with Black, Indigenous, women of color clients

This research summary can be incorporated into a lecture or shared with students as a reading to demonstrate how psychological science explores the diversity of human experience. This resource can also be used to encourage students to identify the major components of a research study (i.e., the hypothesis or study question, sample, method, and findings). Students can be asked to identify potential limitations of the study and encouraged to discuss the implications for our understanding of human behavior. Keywords highlight how concepts within and across pillars are incorporated into a single research study.

When a therapist commits microaggressions (slight, subtle othering experiences related to one’s identities that may or may not be intentional), does that negatively impact therapy outcomes for Black, Indigenous, and People of Color (BIPOC) in therapy? This study sought to better understand how microaggressions related to a therapy client’s race (e.g., therapist seems unaware that racism exists) and gender (e.g., therapist cautions a woman against being “too” assertive) could be associated with therapy outcomes. The research team was also interested in whether two aspects of therapy, working alliance (the closeness between client and therapist) and cultural humility (a therapist’s understanding and appreciation of the role of culture in a client’s everyday experience) might intervene in the relationship between microaggressions and outcomes. The study included the experiences of 288 BIPOC women who had been in therapy. Using both correlations and more advanced analyses (e.g., path analysis), they found that both racial and gendered microaggressions were associated with less positive therapy outcomes, and that microaggressions were related to worse cultural humility and lower working alliance. The path analyses suggested that all of these variables were associated in the following way. Microaggressions were related to lower cultural humility of the therapist, which was linked to a less positive working alliance between the therapist and client, which was connected to poorer therapy outcomes. Together, the researchers suggest that both cultural humility and working alliance should be considered by therapists who are working with BIPOC women.

DeBlaere, C., Zelaya, D. G., Dean, J.-A. B., Chadwick, C. N., Davis, D. E., Hook, J. N., & Owen, J. (2022). Multiple microaggressions and therapy outcomes: The indirect effects of cultural humility and working alliance with Black, Indigenous, women of color clients. Professional Psychology: Research and Practice, 54(2), 115–124. https://doi.org/10.1037/pro0000497opens in new window

Race, Mental Health, Therapies, Psychological Treatment, Discrimination, Disparities

The development of resources to broaden diversity and representation in the teaching of high school psychology resources is an APA Committee of Teachers of Psychology in Secondary Schools initiative supported by funding from the American Psychological Foundation David and Carol Myers Fund. This resource was developed by Eric Castro, Shawn C.T. Jones, PhD, Allyn Olsen, and Catherine Sanderson, PhD.