Broaching Multicultural Considerations during the Initial Clinical Interview

Counseling professionals are committed to providing multiculturally competent services to the clients they serve. When clients first enter counseling, the therapeutic relationship typically begins by the counselor conducting an initial clinical interview. This initial clinical interview is a critical time to demonstrate cultural competence. Currently, there is no literature that has explored how counselors who work with the substance use population incorporate multicultural considerations during the initial clinical interview. The purpose of this study was to explore whether licensed professional counselors (LPCs) broach (Day-Vines et al., 2007) multicultural considerations during the initial clinical interview with clients who have substance use disorders (SUDs). The exploration of this phenomenon occurred through the use of a qualitative methodology. Semi-structured interviews were conducted with nine LPCs in Virginia. The LPCs shared their lived experiences conducting initial clinical interviews with members of the SUDs population. Four themes and a subtheme emerged related to how LPCs perceive the relevance of identifying multicultural factors in their work with the SUDs population: everyone has culture and it is all encompassing, culture is needed to understand clients (subtheme), multicultural factors impact substance use behavior and patterns, cultural identities emerge during the initial clinical interview, and multiculturalism was an important component in counselor preparation. Three themes emerged related to how LPCs describe the term and concept of broaching: no familiarity with the "broaching" term, broaching defined as initiating a topic, and some degree of understanding of the broaching concept. Five themes emerged related to whether and how LPCs introduce or broach multicultural considerations during the initial clinical interview: broaching approach varies, client introduces multicultural factors, appropriate timing, willingness to be open, and boundaries surrounding broaching. The themes that emerge from this data will help to fill gaps in the literature concerning how counselors broach multicultural considerations, particularly with the SUDs population. Implications for counselors and counselor education are discussed. The limitations of the study and recommendations for future research are provided.