(PS6-77) Cultural Influences on the Therapeutic Alliance Between Asian American College Students and Mental Health Clinicians

Abstract Text: Cultural barriers can contribute to dissonance within the therapy room because of the lack of knowledge surrounding how differing cultures contrast and conflict with one another; despite growing recognition of the importance of cultural competence in therapy (Leong et al., 2011), Asian Americans remain underrepresented in mental health research and face significant barriers to care (Yang et al., 2020). Understanding these cultural influences may be critical for improving therapeutic outcomes. This project explores the role cultural factors play in shaping the therapeutic alliance between Asian American college students and their mental health clinicians. In this study, we interviewed (N=9) participants using semi-structured interviews, about their experiences with racism, their racial identity, and how they have discussed these issues with their therapist. Using an inductive approach, we derived themes exclusively from the participant’s transcriptions (Bager-Charleson et al., 2023). Our thematic analysis identified four major themes: (1) cultural barriers creating dissonance within therapy, (2) stigma surrounding help-seeking, (3) therapists unintentionally imposing Western models of mental health, and (4) the need for more culturally competent clinicians who understand Asian American identities. Many participants described feeling misunderstood by their therapists, leading to self-censorship and weakened therapeutic relationships. Consistent with other studies, the stigma surrounding therapy also contributed to internalized shame and reluctance to seek help (Leong et al., 2011). Some of these themes are consistent with existing literature such as the stigma behind seeking mental support (Hynes, 2019), but this study uniquely found a consistent dialogue highlighting participants’ frustration with clinicians pushing Western cultural values onto their clients, without respecting the background that their client might hold. The findings underscore the urgent need for culturally competent mental health care that acknowledges and integrates culture. Enhancing clinician awareness of these nuances can foster stronger therapeutic alliances and improve treatment retention. Future research should examine the role of shared racial/ethnic identities between therapists and clients in promoting culturally responsive care.