Cross-Cultural Approach

When relating to adolescents, it can be helpful to use research on multicultural psychotherapy as if the different developmental status was a separate adolescent culture of its own (Sommers-Flanagan and Sommers-Flanagan, 2007; Sommers-Flanagan, Richardson, & Sommers-Flanagan, 2011). Tailoring treatment according to the unique features of the adolescent's culture may be priceless in creating a bond with the therapist, engaging the patient in treatment and motivating their commitment to the process. On the other hand failing to consider the cultural (age related-) differences may damage the therapeutic relationship and treatment outcome (Nelson & Nelson, 2010; Sommers-Flanagan, Richardson, & Sommers-Flanagan, 2011). The key principal for many adolescents would be the emphasis on self-expression and autonomy, a consequence of the identity formation process they undergo mostly during that phase. Therefore, in most cases, tailoring treatment to adolescent culture should be expressed by strengthening expressions of independence and personal interests. Therapists should be encouraged to express and emphasize the distinctive qualities they notice in the adolescent in front of them, and openly disclose their appreciation by using those insights in a direct conversation with the adolescent (Sommers-Flanagan and Sommers-Flanagan 2007; Sommers-Flanagan, Richardson, & Sommers-Flanagan, 2011; Steketee, 2012). The therapist must keep in mind that emphasis should be placed upon the adolescent's individuality and independence while delicately balancing those principals with parental involvement in a way that would contribute to the success of the treatment (Nelson & Nelson, 2010). Likewise, incorporating activities other than a face to face conversation in therapy with adolescents may be a valuable tool. It can increase participation in sessions and the probability of successful treatment completion, form a stronger therapeutic alliance, and serve as a tool for conceptualizing therapeutic terms and principles. Naturally, alternative activities create more interest than verbal discussions alone and offer new communication channels. When therapists take part in situations other than direct conversation, they can discover features of the personality of the patient that might not appear otherwise (Cheung, 2006 in Thompson et al., 2009; Thompson et al., 2009; Gil & Sobol, 2005). Nevertheless, as always in cross-cultural approaches, the therapist should evaluate the relevance of the cultural characteristics of each adolescent individually, and be aware of the significantly different variations that exist in each group (Nelson & Nelson, 2010). The therapist must take into consideration that as the years go by, there is an ongoing change in the culture of young people. It is similar to the swings in trend in music, fashion, culture and norms, which occur from one decade to another, and during each decade. Therefore, any intervention with adolescents must begin with learning and understanding the contemporary essence of the culture of the specific adolescent. In fact, it would be misleading to assume the therapist’s personal experience during adolescence enables him to predict the essence of the experience the young person he is treating is facing now. For the adolescent in question, such approach may seem as condescending and as ignoring their individuality. It is advised to approach them with a straightforward, non-judgmental and non-presumptuous attitude, and not make suggestions without sufficient information. It is advised, however, to express the therapist's intention to involve the patient in the therapeutic process and decision-making (Sommers-Flanagan & Sommers-Flanagan, 2004a). In accordance with this theory, a critical factor in the ReachingOut framework is tailoring the treatment and the conversation to the patient's world. By finding the right language and tone of the conversation, and suiting them to every patient's preferences and circumstances, the therapist can develop the right approach and find the right phrasing to assist achieving therapeutic goals. The chosen phrasing is determined in real time while maintaining eye contact with the patient and exploring the effect of the phrasing on him, in order to adapt the phrasing if necessary. Holding session in the adolescent's home is an essential tool, enabling non-verbal contact with the adolescent's world.