That psychotherapy is not a value neutral process and that psychotherapists influence their clients' values are well-accepted facts (e.g., Frank & Frank, 1991; Tjeltveit, 1999). However, research on how mental health values are expressed and negotiated over the course of psychotherapy when the therapist and client are culturally different is scarce. This study was a critical qualitative research investigation (Carspecken, 1996) of mental health values expressed in the therapy process by both a therapist and client. The investigator analyzed 12 complete sessions between a White American male therapist and a Korean female client. The cross-cultural dyad was selected because this investigator believed that the cultural differences between the therapist and client would likely lead to a series of value negotiations which in turn could elucidate a value communication process.

Data analysis identified 11 psychotherapy values communicated by the counselor, which were categorized into three groups: (1) values related to the client's or the counselor's self, (2) values related to the therapy (i.e., how it "ought" to be), and (3) other values that did not belong in the first two groups. Psychotherapy values were defined as what is healthy, what should happen during psychotherapy, and how therapists should relate to their clients. Various methods were used by the therapist to communicate what he believed to be healthy, including: (1) stating the value outwardly, (2) repeating certain ideas about mental health over the course of therapy, (3) using self-disclosure as a means to showcase optimal mental health, (4) choosing to explore certain topics over others, and (5) providing positive feedback on client behaviors that were consistent with his mental health values. Results also showed that the client's values changed over time, becoming similar to the counselor's values. Lastly, the counselor's strong emphasis on individual psychological processes—combined with his seeming lack of multicultural competence—likely contributed to his failure to initiate discussion about the client's cultural adjustment. Implications for value communication in counseling and for work with international students based on the findings of this study were discussed.