Degree Date

8-2026

Document Type

Dissertation - Public Access

Degree Name

Psy.D. Doctor of Clinical Psychology

Academic Discipline

Psychology

First Advisor

Lisa Costas, PhD

Second Advisor

Sharie Fabregas, PsyD

Abstract

Intercultural romantic relationships have become an increasingly prominent feature of contemporary society due to globalization, migration, and cross-cultural exchange (Livingston & Brown, 2017). However, these partnerships are also associated with elevated levels of relational distress and higher rates of conflict, separation, and divorce, underscoring the need for culturally responsive approaches in couple therapy (Bustamante et al., 2011; Genç & Su, 2021).

Research on intercultural couples remains limited both within and beyond Emotionally Focused Therapy (EFT), and despite increased recognition of cultural factors, there is still insufficient guidance on navigating differing cultural contexts within a dyad (Linhof & Allan, 2018).

The present dissertation critically examined the appropriateness of EFT for intercultural couples and proposed culturally attuned adaptations to its clinical application based on this review’s findings. The unique needs of intercultural couples, highlighting common stressors, relational challenges, as well as strengths and protective factors are discussed. Implicit and explicit cultural assumptions embedded within EFT, including questions surrounding the universality of attachment theory and potential areas of misattunement, are also explored. While core attachment needs, such as emotional accessibility, responsiveness, and engagement, appear to be globally relevant (Mesman et al., 2016), cultural norms vary significantly in how emotions are expressed (Mesquita et al., 2014), how relational bonds are organized (Sandberg et al., 2024) as well as in expectations of therapist directiveness and authority (Liu & Wittenborn, 2011).

Recommendations that address the integration of cultural values in applying EFT and provide guidance for incorporating cultural awareness across all three stages of the model are included. Therapists are encouraged to expand intake procedures, integrate cultural context into cycleconceptualization, and flexibly adapt core interventions such as the EFT Tango with its enactments while maintaining fidelity to the model. Concrete recommendations include cultural metacommunication, culturally responsive micro-interventions, attention to hierarchy, power, and gender norms, and ongoing therapist self-reflection supported by culturally informed supervision.

This critical review contributes a culturally responsive extension of EFT, with practice adaptations detailed in Appendix A. Future research should prioritize empirical investigations of EFT with intercultural couples, particularlyexamining how cultural responsiveness and tailored adaptations influence intervention effectiveness across EFT stages.

View Full Text

Share

COinS