The development of the Broaching Assessment Scale: A client-rated measure of therapists' broaching behaviour in clinical counselling.

Objective: Addressing ethnic-cultural topics during the process of psychotherapy, i.e. broaching, is considered highly important for ethnic minority clients who consult mental health care services. Surprisingly little is known, however, about clients' perception of a therapist's broaching qualities, and how clients' mental construction of broaching translates into behavioural broaching acts a therapist may display.Method: Based on previous work and nine in-depth interviews with ethnic minority clients, a client-rated measure of therapists' broaching behaviour was developed and psychometrically evaluated in two samples. Sample 1 (N = 252 UK ethnic minority clients) was used to empirically delineate the factor structure of an initial item set. Participants were then resolicited to complete a revised item pool.Results: The empirical structure resulted in a final 25-item broaching instrument with five subscales probing into therapists' broaching behaviour. This Broaching Assessment Scale (BrAS) was validated in Sample 2 (N = 239 US ethnic minority clients). Strict measurement invariance of the factor structure was observed across the two samples and distinctive correlational patterns with therapeutic process measures were found.Conclusion: The BrAS provides new insights on how sensitivity to ethnic-cultural topics can be targeted along its concrete features, and is a promising tool for conceptualizing culturally sensitive mental healthcare assessment.

Addressing cultural topics during psychotherapy: Evidence-based do's and don'ts from an ethnic minority perspective.

OBJECTIVE: Broaching-i.e., a counsellor's effort to install meaningful conversations in psychotherapy concerning one's cultural identity-is a strong predictor of positive treatment outcomes and client satisfaction, especially for minority-identified clients. Despite this understanding, the broaching literature has struggled to translate broaching principles into practical recommendations for specific behaviours and skills. The current study therefore explores the effects of broaching approaches by the therapist (i.e., direct, indirect and avoidant approach) about cultural topics including ethnicity, religion, gender expression and socioeconomic status on clients' perception of (1) the multicultural orientation of the therapist and (2) the frequency of microaggressions during therapy. METHOD: These research questions were investigated in a sample of ethnic minority clients (N = 231) who followed at least one session of mental healthcare counselling during the last 12 months. RESULTS: Findings show that indirect broaching is the overall most favourable approach, whilst avoidant broaching is consistently negatively associated with all therapy-related outcome measures. CONCLUSION: The results lay the basis for practical guidelines for broaching in psychotherapy, and provide counsellors with a foundation for having cultural conversations in an effective and respectful manner.