Establishing therapeutic alliance across cultural barriers.

1. The therapeutic alliance is a mutually defined helping relationship that encompasses mutual respect and acceptance of ethnocultural variance, predicated upon empathic rapport. 2. Sensitivity to two psycholinguistic phenomena may help establish a transcultural relationship: the detachment effect (limited expression of affect and reduced access to developmental events between languages) and code switching (a complete or partial change of language or dialect within a single utterance or conversation). 3. Issues related to differing sociocultural expectations of nurses and clients will be increasingly encountered as ease of travel combines with economic and political unrest to produce increasing numbers of displaced persons.