The Impact of Social Stigma on the Therapeutic Relationship for Latino Clinicians: The Elephant in the Room?
Social stigma is consistently mentioned in the literature as one of the barriers preventing Latinos from seeking, accessing and remaining in mental health care. This study focuses specifically on social stigma as a barrier to remain in psychotherapy. Social stigma is understood as the internalized fear of severe social disapproval for behaving against acceptable cultural meaning systems. With intersubjective theory as the analytical framework, this study primarily explores, through a series of focus groups with Latino mental health service providers of Latino clients, the perceptions those practitioners have regarding the influence of social stigma on the therapeutic relationship and the ways they address this issue in their practice. The constant comparison method from a grounded theory perspective and the software NVivo, as an auxiliary, were used for data analysis. It was found that social stigma is perceived by participants as inextricably linked to the engagement process. It is not seen as playing a significant role in the dropout of clients from therapy. Participants see themselves as responsible for engaging their clients and eventually addressing any barriers they may bring to the therapeutic encounter, including social stigma. The most common strategies reported by participants to fulfill these responsibilities are the use of flexible boundaries when interacting with clients, and the use of psychoeducation to inform them about the meaning and implications of the therapeutic process. Participants strongly recommend the use of groups as a therapy modality for effectively engaging clients and addressing the issue of social stigma.
Behavioral health, Latinos, Psychotherapy, Social stigma, Therapeutic relationship, Social Work
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