Worldviews, cultural views and family beliefs influence the manner in which a person approaches making decisions, problem solving, and one's attitude toward life. Recognizing this is a necessary component in order for cross-cultural therapy to be effective. In dealing with the contemporary world, it is desirable for therapists to examine and understand psychotherapy broadly, not only vertically across time, but horizontally across cultures, in order to grasp the overall experience of human beings with regard to theories, knowledge, and practices involved in the healing of the mind (Tseng, 1999). .
Varma (1988) defines Western individual psychotherapy as an "interaction, indeed a contract between two autonomous adults, operating at about equal level with each capable of assuming full responsibility for his actions and emotions." She recognizes that psychotherapy is limited mostly to a verbal interchange requiring introspective ability sufficient to appreciate conflicts in intrapsychic terms and to translate and express it in words. Cultures vary in interaction and communication styles, which therefore requires psychotherapy to make the necessary modifications in accordance with culture. One can distinguish psychotherapy from other methods of psychological healing because it requires a person to talk about his actions, emotions, and thoughts in order for change to be possible. This form of healing demands that a person be willing to engage in conversation about private and interpersonal experiences. According to the customs of North American society, it is encouraged that people speak out about their private relationships and feelings. Various television shows in which people are encouraged to divulge their personal thoughts, feelings, and behaviors exemplify this attitude. .
The extraversion of U.S. society has led practitioners to put more emphasis on what is said rather than what is unsaid in psychotherapy.
