Dynamics of the relationship in clinical work with African-American clients

The high drop-out rate from psychotherapy for minority clients signals the need for increasing our skills with this population and exploring the possibility of treatment innovations. However, at the same time, there are developments in traditional psychodynamic theory that are relevant to work with African-American and other minority clients. The emerging emphasis in modern psychoanalytic theory on the therapist-patient relationship as a medium of change provides the background for this paper. Black clients typically operate in an interpersonal mode in the early phases of therapy. Unless they satisfy themselves as to the therapist's capacity to be sensitive to their sociocultural as well as to their personal situation, these clients often will not move into an instrumental mode, that is, one of working on the personal problems that brought them. In this paper, the dimensions of empathy and countertransference are discussed with respect to their particular relevance for Blacks in treatment and in the context of a telic-humanistic approach to psychology.A version of this paper was presented at the Conference on Ethnic Minority Perspectives in Human Development and Clinical Psychology held at the University of Massachusetts-Boston, May 15–16, 1986.