Date of Award

December 2017

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Marriage and Family Therapy


Keith A. Alford

Second Advisor

Linda Stone Fish


African Americans, Marginalization, Marriage and Family Therapy, Self of the Therapist, Social Justice, White Privilege

Subject Categories

Social and Behavioral Sciences


The consideration of one’s cultural context is a critical component of systemic therapy. Marriage and family therapy literature underscores this importance with a wealth of information on working with various diverse family systems. The literature has not adequately reflected the voices of the African American client. The purpose of this study was to understand the African American experience in relational therapy with White clinicians. Phenomenological methodology was employed via semi-structured interviews with eleven participants across the United States. The findings revealed three themes (lived experiences of African Americans, lack of culturally responsive clinical practice, and what works in therapy). The data also culminated in a formula that demonstrates the failure to practice through a culturally responsive lens. Inversely, a second, corrective, formula was proposed to attend to the cultural context of the client. There was agreement on what made treatment a positive experience which clustered around the character of the therapist, the therapist’s regard and respect for the client, and the level of skill demonstrated as part of the therapeutic work. Clinical recommendations include a more systemic approach to training therapists. Training from both a social justice and a self of the therapist lens is important as it allows clinicians to understand their impact. In systems theory, clinicians become a part of the client system to create a context in which change can occur (Becvar & Becvar, 2013). If a clinician does not understand themselves within the context of social justice dynamics, they risk subjecting their clients to the same injustices in therapy as they face consistently in their day to day lives. To ensure effective, culturally responsive clinicians in training, other levels of the system need to engage beyond administrative, fiduciary, and gatekeeper duties.


Open Access