Ethnic and Racial Identity and the Therapeutic Alliance

Learn why a racial match might not always be a good idea.

Posted Mar 20, 2018

How do People Connect With Their Culture?

About Ethnic Identity

Ethnic identity is a multifaceted concept consisting of how people develop and experience a sense of belonging to their culture. Traditions, customs, and feelings about one’s heritage are also important factors in ethnic identity development. Individuals progress through different stages as they learn to identify with their culture, whereby they come to understand the group customs and values, and ultimately identify with their ethnic group. Different models have been studied, and it is widely agreed that in order to achieve a strong sense of ethnic identity, people first go through a thorough process of exploration of their culture (Phinney, 1992). This exploration process has different stages, and the strength of an individual’s ethnic identity will depend on the stage the person is in within the process.

Phinney (1990) believed that the exploration process consists of three stages: an unexamined stage, a searching stage, and an achieved or integrated stage. People who have not explored or examined their culture remain in the unexamined stage. This stage may also be characterized by negative feelings toward their ethnicity due to the lack of direct connection to it. The searching stage is when people become interested in joining their ethnic group and begin to develop their own ethnic identity; this is characterized by a process where efforts are focused on the expression of their commitment to their identity. After carefully building their place within their ethnicity, they become more acquainted with the existence of others’ identity and appreciate that they have an ethnic heritage to share. This is when they are said to be in an achieved or integrated stage.

The development of ethnic identity has been researched primarily in adolescents across different cultures. Studies have found that a stronger ethnic identity is correlated with better psychological well-being and higher self-esteem. Ethnic identity is thought to develop in early adolescence through young adulthood. As a result, relatively less is known about the ethnic identity processes in older populations, but it should not be assumed that one’s ethnic identity ceases to develop after adolescence.  Additionally, ethnic identity can vary based on demographic factors. For example, among African Americans, there are higher levels of ethnic identity present in the South compared to other regions (Williams, Duque, Chapman, Wetterneck, & DeLapp, 2018).

Early Models of Ethnic Identity Development

The concept of ethnic identity has been studied within several areas of psychology. In social psychology, Tajfel, and Turner (1986) developed the idea that ethnic identity is inherently a social event. Crucial to the development of ethnic identity are the social gatherings or groups to which people ascribe. They observed that several ethnoracial groups have had difficulties due to stereotyping and prejudice. Therefore, these groups have developed a process of self-affirmation to maintain their sense of commitment and self esteem via their culture, and this sense of affirmation is particularly strong in members of African American communities. Subsequently, additional models have been developed to determine how identity development may differ across cultures.

William Cross developed his highly influential model of Nigrescence to explain the process of identity development in African Americans. The original model contained five stages of development: Pre-encounter, Encounter, Immersion, Emersion, and Internalization (Cross, 1978). After a careful reassessment, the model went through a revision process to create the present expanded Nigrescence theory (Cross, 1991). Where the original model included five stages of development, the revised one presented three stages of group racial identity attitudes: Pre-encounter, Immersion-Emmersion, and Internalization. The Pre-encounter stage is marked by an opposition or low acceptance to the Black race and culture; it is characterized by self hatred and a desire for assimilation into white culture. After greater involvement with one’s ethnic group, the individual will enforce pro-Black attitudes. This is known as the Immersion-Emersion process as individuals increase their desire to represent their black heritage and reject other cultures; they later come to accept their role as a Black individual in a racially diverse community. Internalization determines a final stage of being reconciled with a multicultural society. Here the individual will demonstrate a mature state of ethnic identity where they show attitudes that are more accepting of other cultures.

Minority Identity Development

The Cross model was later expanded by others to include all people of color (e.g., Minority Identity Development Model; Atkinson, Morten & Sue, 1998; Racial and Cultural Identity Development Model; Sue & Sue, 2016). Minority development models may include the stages referred to as Conformity, Dissonance, Resistance, Introspection, and Integrative Awareness. In the Conformity Stage, people of color accept the values of the majority culture without critical analysis. In this early stage they may value White role models, White standards of beauty and success, and may believe it is better to be White.  Thus, there may be underlying negative emotions toward the self as person of color. As a result, they may reject a same-race therapist and view the White counselor as more desirable and competent. In the Dissonance Stage, individuals begin to acknowledge the personal impact of racism when a triggering event causes the person to question and examine their own assumptions and beliefs. They become more aware of racism and experience confusion and conflict toward the dominant cultural system.  In the Resistance Stage, they actively reject the dominant culture and immerse themselves in their own culture. They may feel hostility toward White people in this stage and reject a White therapist. In the Introspection Stage the person of color starts to question the values of both his/her own ethnic group and the dominant group. The person becomes more open to connecting with White people to better learn and understand differences.  In the final stage, Integrative Awareness, the person develops a cultural identity based on both minority and dominant cultural values. They feel comfortable with themselves and their own identity as a person of color in a multicultural society. As minority clients reach more advanced racial identity statuses, they become more inclined to appreciate counselors of their same race. Although those with a strong positive ethnic identity will recognize they might be able to benefit from a competent therapist of any race, and the person of color has no fears about confronting racial issues with a White therapist when needed.

White Identity Development

The development of racial identities and racial consciousness was limited to the study of ethnic minorities for many decades, and it was not until the late 1980’s that the idea of White racial identity become a topic of interest in psychological research. One of the most significant researchers in the field of white racial identity theory is Dr. Janet Helms, a psychologist who initially defined a structure of white racial identity and its stages of development. Her theory includes six intertwining ego statuses (Helms, 1990), described as:  Contact – where one denies racism/cultural differences/dominant group membership, and may be colorblind or insensitive to racial differences; Disintegration – where one experiences conflict over moral dilemmas between choosing one’s ethnic group and greater humanity goals; Reintegration – where there is some resolution of dilemma, by becoming intolerant of other groups and taking a racial superiority bias; Pseudo-independence – where one begins limited acceptance and efforts to connect with people of color that share similarities; Immersion/Emersion – where one develops increased understanding and acceptance of white privilege but may still act based on guilt; and Autonomy – where one has gained acceptance of one’s whiteness, understand the role one plays in perpetuation of racism, values diversity, and feel less fearful and less guilty about the reality of racism.

To Match or Not To Match

Why match? Most clients feel more comfortable discussing psychological problems with someone of the same ethnic and racial background, and they may answer questions about symptoms more accurately when matched. Ethnic minority clients may perceive their counseling experience to be more effective when they are with someone who has a native understanding of their culture. Matching has been shown to strengthen the therapeutic alliance and improve retention.

Why not match? Cultural matching is not always possible due to a lack of availability of a clinician of the same ethnicity as the client. Also, it may not be desirable from client’s perspective if the client feels the choice is being made for them due to race. Further, a client might not want a person of their own ethnicity for various reasons, for example, they may not be adhering to their group’s cultural traditions and so may worry about judgment from someone from the same ethnic group. Furthermore, unmatched dyads provide an opportunity for expanded awareness and greater cross-cultural understanding in both the client and therapist.

Ethnic Identity in Therapy

The figure below illustrates how racial identity can impact the rapport and trust between the therapist and a client of color, based on stage of identity development in the client.

Adapted from Parham, Ajamu, & White (2011) / M. Williams
Source: Adapted from Parham, Ajamu, & White (2011) / M. Williams

This analysis does not take into account the more complex picture of what may occur between client and therapist when a therapist is also struggling with his or her own identity development. For example, a Black therapist in an early stage of racial identity development may feel hostility toward a Black client, resulting in distancing and an unsuccessful therapeutic alliance. A White therapist in an early stage may become upset and defensive when confronted with racially charged material from a client of color. Assumptions should not be made about goodness of fit based on race in advance of an assessment of racial identity development in both the client and therapist. That being said, there is very little research on how these models of racial identity development impact the therapeutic relationship, but for an interesting theoretical model see Helms (1984).

The models presented here can help clinicians develop a more effective therapeutic alliance and contribute to a fuller understanding of the client’s presenting concerns and subsequent diagnoses. Conversations with a client about their many identities and the importance (or lack thereof) of these identities are encouraged early in the assessment process as part of an ongoing conversation that incorporates these contextual frames throughout psychotherapy.

References

Atkinson, D., Morten, G., Sue, D.  (1998). Counseling American Minorities.  McGraw Hill: New York, NY.

Cross, W. E. (1978). The Thomas and Cross models of psychological nigrescence: A review. The Journal of Black Psychology, 5, 13-31.

Cross, W. (1991). Shades of Black: Diversity in African-American identity. Philadelphia: Temple University Press.

Erikson, E. (1968). Identity: Youth and crisis. New York: Norton.

Helms, J. (1984).  Toward a theoretical explanation of the effects of race on counseling: A black and white model. The Counseling Psychologist, 12, 4.

Helms, J. E., & Carter, R. T. (1990). Toward a Model of the White Racial Identity Development. In J. E. Helms (Ed.), Black and White racial identity: Theory, research, and practice, 49-66. Westport, CT: Greenwood Press.

Marcia, J., Waterman, A., Matteson, D., Archer, S., & Orlofsky, J. (1993). Ego identity: A handbook of psychosocial research. New York: Springer-Verlag.

Parham, T. A., Ajamu, A., & White, J. L. (2011). Chapter 8: Mental Health. Psychology of Blacks: Centering Our Perspectives in the African Consciousness, 4/E. Pearson.

Phinney, J. (1989). Stages of ethnic identity development in minority group adolescents. Journal of Early Adolescence, 9, 34–49.

Sue, D. W. & Sue, D. (2016). Racial/Cultural Identity Development in people of color: Therapeutic implications, Chapter 11. In Sue, D.W. & Sue, D. (Eds.), Counseling the Culturally Diverse: Theory and Practice (7th ed.) Hoboken, NJ: Wiley.

Tajfel. H., & Turner. J. (1986). The social identity theory of intergroup behavior. In S. Worchel & W. Austin (Ed.), Psychology of Intergroup Relations (pp. 7-24). Chicago: Nelson-Hall.

Williams, M. T., Duque, G., Chapman, L. K., Wetterneck, C. T., & DeLapp, R. C. T. (2018). Ethnic identity and regional differences in mental health in a national sample of African American young adults. Journal of Racial and Ethnic Health Disparities, 5 (2), 312–321. doi: 10.1007/s40615-017-0372-y