How can psychotherapists improve their practice with service users from minoritised ethnicities? An application of the Declarative-Procedural-Reflective (DPR) model of clinical skill development

Abstract

Abstract Many white psychotherapists may lack the skills required to work effectively with service users from minoritised ethnicities. This article proposes that the nature of this skills deficit can be understood through applying the Declarative-Procedural-Reflective (DPR) model of therapist skill development. The DPR model has been used in a range of psychotherapeutic contexts, and it provides a systematic account of how therapists from all modalities develop and can improve their skills. Adapting this model to white therapists’ skills in working with service users from minoritised ethnicities allows the identification of specific areas of skills deficit, and therefore clear recommendations as to how to address those deficits. The application of the DPR model to this context suggests that there are clear areas of skills deficit in terms of knowledge base, the practical skills of carrying out therapy, and the ability of therapists to reflect on their work with service users from minoritised ethnicities. I conclude by making a number of suggestions as to how those deficits could be addressed, both by individual therapists and at a systemic level. Key learning aims (1) To explore why some white psychotherapists find it more difficult to work effectively with service users from minoritised ethnicities. (2) To conceptualise difficulties in working with service users from minoritised ethnicities as an issue of clinical skill, knowledge and attitude development, where therapists’ skills can be improved if specific deficits are appropriately addressed. (3) To use the structure of the DPR model to better understand how deficits in therapists’ skills, knowledge and reflective ability may have an impact on their work with service users from minoritised ethnicities. This allows the identification of specific areas of deficit, and therefore clear recommendations as to how to address those deficits. (4) This is primarily addressed at CBT therapists, but the points raised in this article apply to all schools of therapy.