Relationships are at the heart of all psychotherapies, as the therapeutic relationship serves as the bedrock for change and relationship issues are often the core concern of clients. Further, immigrants, refugees, and diverse clients often experience losses, changes, and conflicts in their relationship. Although attachment theory has empirical support and is clinically helpful, a much broader understanding of relationships can come from the application of cultural concepts (e.g. amae, jeong, yuan-fen, and familism); non-Western philosophies (e.g. Confucianism, Taoism, and Buddhism); and models that capture diverse cultural orientation and values (e.g. Horizontal and Vertical Individualism Collectivism model). A stepwise culturally competent approach, using RELATE (Relationship-building, Exploration of individual and sociocultural meaning, Laying off of cultural assumptions, Address sociocultural issues, Therapeutic use of culture, and Evaluation of impact), can help guide psychotherapy. Interventions may include pro-cultural or countercultural strategies. Ultimately, the use of a cultural lens can help the psychotherapist and the client to not only manage relationships, but also make them thrive.
