Intensive psychotherapy is principally limited to the middle class and the affluent population. Working class individuals utilize individual psychotherapeutic services at a low rate, and members of American ethnic groups (including "white ethnics") probably have even lower utilization rates. The reasons that therapists and ethnic clients avoid each other is that their values and cultural assumptions are often so different as to preclude an effective therapeutic relationship. The therapist assumes that a patient is there to work through his or her problems as an independent individual, motivated by the belief that all problems lend themselves to solutions. Ethnic patients, on the other hand, have often been socialized in subcultures in which the values of independence and individualism and the idea that people control their own lives are missing or irrelevant. Therapists must be able to take distance from their own world views and understand patients' ways of ordering their own psychological realities. If an ethnic patient's problems are due to conflict between his/her traditional social values and the values of dominant middle class America, the therapist should be able to help the patient to clarify the discrepancy and resolve the conflict. (Author/GC)