Invisible Outsiders: Developing a Working Alliance with Appalachian Clients

• Main Authors: Protivna, Jake J., Pusateri, Cassandra G., Paylo, Matthew J., Choi, Kyoung Mi
• Format: Others
• Published: Digital Commons @ East Tennessee State University 2017
• Subjects: Appalachia; cultural competence; diversity; counselors; working alliance; Counseling and Human Services; Education
• Online Access: https://dc.etsu.edu/etsu-works/3156; https://dc.etsu.edu/context/etsu-works/article/4254/type/native/viewcontent

Appalachian clients are often ‘invisible’ within the majority culture and possess characteristics unique to the region that must be considered within the counseling relationship (Tang & Russ, 2007). Individuals in Appalachia have higher incidences of certain mental health disorders and substance use as compared to the national average (Appalachian Regional Commission [ARC], 2008). Although the need for mental health services is evident, limited research exists to inform mental health professionals how to deliver culturally competent interventions to build a working alliance with Appalachian clients. The authors will discuss a framework for mental health professionals to develop a strong working alliance through a review of the cultural distinctions of Appalachian individuals, culturally appropriate counseling interventions, and a case illustration.