There is a need for culturally attuned approaches for couple’s therapy with Mexican/ Mexican-American people (Falicov, 2009). However, there have been few theoretical frameworks to conceptualize cultural attunement, and attunement has been primarily understood as a skill or as an attitude rather than as a relationship or as a series of clinical concepts with steps to follow (Hoskins, 1999; Oakes, 2011). From the social constructionist perspective, cultural attunement is related to the cultural context and cultural interactions that shape beliefs and attitudes about what is meaningful in establishing deep relationships for Latino and non-Latino therapists and their Mexican and Mexican-American couple clients. Though the Mexican and Mexican-American population is the object of many studies, few have addressed their experiences in the therapy room. Consequently, this qualitative grounded theory study utilized in terviews with 11 client couples of Mexican heritage and 14 marital and family therapists to shed light on how Latino and non-Latino therapists co-construct positive experiences of cultural attunement with Mexican and Mexican-American couple clients. Four interrelated phases of the process were identified: (1) mutual invitation, (2) shared engagement, (3) co-constructing deeper connections, and (4) creating cultural connections. Reaching cultural attunement in this study was a reciprocal, collaborative process that entailed the whole person and all the senses. It began with willingness and engagement on the part of both therapists and client couples and involved sharing of personal stories and emotion and intentional attention to facilitating cultural connections. The Mexican-heritage clients valued professionalism and expertise of the therapist, but felt attuned to and respected when therapists demonstrated humility and engaged in a shared collaborative process. The process appears more likely with Latino therapists; however the findings suggest that cultural matching does not guarantee cultural attunement and clients are open to learning from therapists from other ethnic backgrounds who demonstrate respect for their values and take actions to intentionally connect with their culture.

LLU Discipline

Marital and Family Therapy


Counseling and Family Sciences


School of Behavioral Health

First Advisor

Knudson-Martin, Carmen

Second Advisor

Hernandez, Barbara Couden

Third Advisor

Huenergardt, Douglas

Fourth Advisor

Moline, Mary

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Couples Therapy; Marital Therapy; Hispanic American - Psychology; Interpersonal Relations; Social Identification; Social Perception; Personal Construct Theory

Subject - Local

Cultural Attunement; Latinos; Mexican-Americans



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives