Australian Mental Health Care Practitioners’ Cultural Competence, Therapeutic Alliance, Desirable Responding and Racial/Ethnic Attitudes

Background Racial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country’s population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia’s population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners’ attitudes toward this diversity and their level of cultural competence. Aim Given the relationship between practitioner cultural competence and an effective therapeutic alliance with diverse clients, this study aimed to identify factors that influence non-White and White practitioner cultural competence and therapeutic alliance. Methods An online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Multicultural Counselling Inventory (MCI); the Color-blind Racial Attitudes Scale (CoBRAS); and the Balanced Inventory of Desirable Responding (BIDR). Descriptive statistics were used to summarise participants’ demographic characteristics. One-way ANOVA and Kruskal-Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence, therapeutic alliance, and racial and ethnic blindness. Correlation analyses were conducted to determine the effect of participants’ gender or age on cultural competence and therapeutic alliance. Hierarchical multiple regression analyses were conducted to predict cultural competence and therapeutic alliance. Results The study demonstrates that higher MCI total scores (measuring cultural competence and therapeutic alliance) were associated with being non-White, older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to have higher self-deceptive positive enhancement scores on the BIDR than those with lower MCI total scores. Conclusion The findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play in the therapeutic alliance. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners’ age, racial/ethnic background and professional experience.