Clinician as Bicultural Coach: Integrating Bicultural Identity and Bicultural Competence Into Psychotherapy

Abstract

Clinicians rarely receive training in integrating acculturation into cognitive-behavioral therapy (CBT); however, shifting demographics in the U.S. make this increasingly important. Most evidence-based psychotherapies (EBPs) assume a monocultural, and especially dominant culture, frame of reference which goes against findings from the acculturation literature. Few EBPs integrate sources of acculturative resilience—namely, bicultural identity and bicultural competence. In the clinician as “bicultural coach” approach, we demonstrate how clinicians can incorporate this additional acculturative lens for clients who have experienced acculturation-related stress and build bicultural skills. Through clinical illustrations across a range of CBT assessment, case formulation, and intervention skills that address intrapersonal, interpersonal, and societal domains, we show how this clinician as “bicultural coach” approach adds depth and dimension, thereby enhancing the cultural sensitivity and ultimate relevance of CBT for diverse clients.