Broaching Cross-Cultural Similarities and Differences in Clinical Social Work Practice: Toward Fostering Epistemic and Social Justice

Addressing cultural differences in cross-cultural interactions is a critical component of cultural competence (Choi et al., 2015). It is evidenced as enhancing clinicians’ credibility and effectiveness as well as clients’ depth of disclosure, satisfaction with services, and willingness to return to future services (Day-Vines, et al., 2021; Hare, 2015; Sue & Sudberg, 1996). Scholars urge clinicians not only to recognize socio-cultural-political contexts that impact clients’ presenting concerns but also to demonstrate a willingness to explicitly discuss/broach cultural factors with clients in clinical encounters (Day-Vines, et al., 2021). However, we continue to observe a debate around ‘if’ cultural factors are really relevant in clinical practice, and if so, how do we know? This debate bears several assumptions as if clinical practice space is color-blind, culture-blind; culture resides outside of clinical and psychological realms; and integrating cultural aspects into clinical interactions is optional and conditional. We question what this means to the very existence of the client’s personhood, especially those with multiple identities in marginalized groups, when a social worker ignores and/or discredits the client’s culturally relevant experiences.

This presentation includes three parts. The first one is a critical mapping of empirical studies on broaching. We found 18 empirical studies exploring types, dimensions, and their impacts on the clients’ satisfaction, alliance and outcomes in clinical practice. Main findings included that clinicians of color and/or other minority backgrounds broached more than clinicians with white and/or other dominant backgrounds did about cultural factors and their impact on clients’ presenting issues and cultural differences between the client and clinician. Despite the clients’ experience of the apparent cultural misunderstanding and racial microaggression, the clients reported that there was little discussion around the matter, which impacted their premature termination and dissatisfaction with the services. The second one is theorizing why and how broaching in cross-cultural clinical practice is critical in conducting socially just practice, using critical theories such as epistemic injustice, critical race theories, and whiteness studies. Regardless of broaching, a presence of multiple identities and related marginalization and prejudice is apparent in the client’s experiences and in the clinical dyad. When this experience is dismissed and related discussions are ignored, both testimonial and hermeneutic injustice occur. Combining the current scholarship on cultural competence with critical theories, we develop a model of broaching and bridging in cross-cultural clinical social work practice and illustrate various pathways of broaching and their contexts. Given the empirical studies and our collective clinical social work experience, this concluding section illustrates selected micro-skills of how social workers foster broaching and bridging in cross-cultural encounters in clinical social work practice. The selected skills – clinicians’ self-disclosure, cultural immediacy, and reflective listening – will be presented with case illustrations.