Cultural Influences on Therapy Choice

Hi, I am a student pursuing my master’s in SLP. I was wondering if you have noticed whether certain therapy strategies tend to be more effective for clients of one cultural background than another or whether the same therapy strategies seem to be equally effective universally (taking into account personal differences, of course). Thank you!

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Cultural Influences on Therapy Choice — 2 Comments

  1. Hello, Irene,

    You question boils down to an absolutely critical one: “Is there a one size fits all therapy protocol for people with stuttering problems?” which, I suspect, you know how to answer. And I’m guessing that you would start your response with an emphatic, “No!” But, perhaps, you also know that you can answer that basic question by starting your response with an emphatic, “Yes!”

    As you may be learning, the clinical relationship is the most important therapy tool speech-language pathologists have. And the best clinical relationship, in my opinion, and in the opinion of many counselors I have known (I was a Transactional Analysis trainee.), is one which is colored by mutuality geared toward meeting the client’s best interests. So, “Yes,” we relate to all clients in the same way, as colleagues. We help them help themselves be and live more as they wish.

    And, of course, if we as speech-language pathologists see our role in that way and function accordingly in clinical exchanges, then we will find the most meaningful strategies to help our clients achieve self-realization. So, “No.” The strategies we may introduce to individual clients will vary depending on their expressed needs and preference.

    Culture is one of many variables, such as gender and motivation, that need to be factored into the cultivation of a meaningful clinical relationship, which, as you also may recognize, develops over time and is not fully established as I as a young speech-language pathology student was taught to believe at a first meeting where the goal was “to establish rapport.” How silly and sad that was as a tenet of therapy! But that was a long time ago…

    So, with kindness and empathy and an open-minded curiosity, we choose to relate to the person we call client in ways that will enhance and, occasionally, recover their personal strength to be their own muse in the comedy/tragedy we call Life.

    Best wishes.

  2. Hello,
    Since I work with people from all over the world, I can say with confidence that on the macro level, the strategies that work best are not culturally dependent. However, on the micro level, it is very important to suit the way of imparting these strategies to the individual. There are some cultural differences among people that should be considered. Some of the conversational and reading samples I use are culturally dependent. I work a lot with people whose culture looks at gender, religious, political, social issues different from the way I do. It is important to respect that we are all different and there should be no, even below the surface, attempt to impose your feelings or thoughts on others. I do use cultural examples from the client’s perspective to help them understand how change can be accomplished and I use analogies that come from the client’s life experience. Also, there are some cultures where the public’s attitude toward stuttering is more negative than others. It is important to be sensitive to this when asking the client to disclose stuttering. In New York or London it might seem appropriate to walk up to strangers and announce that you stutter, but in other countries this would be something you could not expect the client to do. In short, we do have to be sensitive to different cultures, but people who stutter all over the world have similar issues related to speaking and the treatment therefore follows the same principles.