Multiculturalism and the Therapeutic Process
Kinzie, J. David, American Journal of Psychotherapy
JUDITH MISHNE: Multiculturalism and the Therapeutic Process, Guilford Press, New York, 2002, $35.00, 268 pp., ISBN 1-5723-0775-7.
As our society grows increasingly culturally diverse, we must adjust our treatments to be sensitive and appropriate to diverse populations. Several excellent books have recently detailed the challenges of providing psychiatric services to patients from different cultures (Tseng, W.S., Handbook of Cultural Psychiatry; Okpaku, S.O., Clinical Methods in Transcultural Psychiatry; Gaw, A.C., Culture, Ethnicity and Mental Illness). Judith Mishne, Ph.D., a professor of social work at New York University, has a more focused approach. Her goal is to describe how psychoanalytically oriented therapy can be used to treat culturally diverse patients. To be sure, the approach is modified, and indeed, the modification results in a sensitivity to patients that is the greatest strength of this book.
Multiculturalism and the Therapeutic Process begins with an introduction on the development and need for cross-cultural therapy, and then follows the analytic model with sections on the beginning, middle, and end phases of the treatment process. Each section usually provides a definition or literature review of the topics covered, such as transference, countertransference, and resistance, with a discussion of the ethnic and cultural factors that influence each of these phases, followed by a detailed case history, illustrating the major points. The author's position, stated throughout the book, is that recent theories of self psychology and intersubjectivity are most relevant to cross-cultural psychotherapy. The latter involves the empathy and awareness of the reciprocal interplay between two or more subjective worlds. This certainly rings true experientially without the need for an abstract theory. The case examples indicate flexibility and honesty that seem unusual in case reports. For example, the first case describes a negative outcome, despite prolonged assessment and competent cultural understanding. …