Intersectional sameness and difference in psychotherapy: Women of colour s experiences of the therapeutic alliance

Isaacs, Faranha

Intersectional sameness and difference in psychotherapy: Women of colour s experiences of the therapeutic alliance

Thesis / Dissertation

2024

Abstract

The therapeutic alliance is crucial for positive therapeutic outcomes, as it sets the foundation for the therapeutic process. In South Africa, a diverse and multilingual country with high levels of inequality, access to healthcare services, poor quality of healthcare, and discrimination in healthcare settings are persistent issues. Women of colour are often disproportionately affected by these health inequities. However, little is known about how sameness and difference are experienced in the therapeutic alliance in South Africa, which makes it essential to explore experiences of women of colour in this context. Using an exploratory qualitative research design, this study recruited and interviewed 11 self-identified women of colour using purposive sampling. Data collected were analysed using a reflexive thematic analysis to identify themes and analyse the findings. Two primary themes emerged: feeling understood and agency. The study suggests that sameness and difference are palpably experienced in the therapeutic encounter. Various factors shaped the role that sameness and difference played in the therapeutic experience, including feeling understood, having agency, therapist disclosure, validation, cultural competence, collaboration/engagement, socioeconomic status, and setting up the frame. Previous research highlights the importance of exploring the therapeutic alliance in diverse contexts, where clients' diversity may influence their therapeutic experiences. The findings of this study contribute to the literature on the therapeutic alliance in diverse contexts and emphasise the importance of acknowledging and engaging with sameness and difference in the therapeutic process. The results have implications for mental health practitioners working with women of colour in South Africa and highlight the need for cultural competence training in the field of psychology. Further research is required to explore the experiences of women of colour in the therapeutic alliance in other diverse contexts. Keywords: therapeutic alliance; sameness and difference; South Africa; psychotherapy; intersectionality

Keywords

Psychology

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