The role of culture and how it shapes an individual’s engagement in therapy: exploring the perceptions and expectations of British-Iranian clients who have accessed psychological therapy.

Access to therapy is hindered for the British-Iranian population. The numbers of Iranian immigrants have been ever increasing in Europe, America, and Canada over recent decades (Office for National Statistics, 2017), with a significant number in the UK. Whilst the British-Iranian community is ever expanding, literature searches revealed little, lacking up-to-date research, particularly regarding British-Iranian clients’ perceptions and expectations of Western therapy (Babak, 2015). This consequently limits the insight available into Western therapies’ effectiveness for British-Iranians. Iranian immigrants experience many challenges, like discrimination, language and acculturation challenges, isolation, and unemployment, leading to mental illness (Shishehgar et al., 2015), and halting help-seeking and therapy (Seifsafari et al., 2013). A lack of understanding, acceptance, and culturally rooted stigma amongst Iranian immigrants (Shirpak et al., 2011) also creates help-seeking disengagement (Heidari et al., 2013) and higher dropout rates (Farrokh, 2010). Current research explores perceptions and expectations of therapy with relation to cultural understanding. A pilot study was undertaken to decipher the effectiveness of the interview schedule; this was then applied to other participants. Data was collected through semi-structured interviews, from eight first- and second-generation British-Iranians (five men and three women) who accessed therapy in the UK. Research utilised Thematic Analysis (Braun & Clarke, 2006), drawing on the phenomenology of Husserl, allowing time, space, and a voice to disclose the participant’s experiences from their perspective. My Findings revealed four master themes: 1. Cultural Influence on Therapy Perceptions, 2. Interaction with the Therapist and the Therapeutic Relationship, 3. Changing Perceptions of Self within the Cultural Context, and 4. The Ever-Evolving Iranian Culture and Perceptions. All of these were relevant to participants’ accounts of therapy expectations and perceptions. These findings can contribute to addressing gaps within existing literature by offering a deeper understanding of the associated challenges of working with British-Iranian clients and developing the relevance and effectiveness of current techniques. Culture influenced participants’ perceptions and expectations of therapy and MH, in turn, affecting their help-seeking ability. Once in therapy, there was generally opposition to cultural norms, yet they found therapy effective. This was not across clients, however, rather promotion and acceptance of therapy tended to vary across clients. There appeared to be a process of acculturation and enmeshment involved in therapy engagement: those who were more accultured embraced therapy and those who were less accultured opposed therapy. Moreover, this appeared to be influenced by the level of psychoeducation.

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