In another paper (Gibbs 2009) I re¯ected on race and culture in the context of therapeutic consultation and assessment. This chapter looks more speci®cally at the impact of race and culture on the process of therapy. It takes for granted that the necessary attention is paid to the therapeutic setting ± a clearly bounded space in time and space. Wilson (1991) de®nes this as the conditions of work that facilitate communication and enable both psychotherapist and patient to observe and think about what is happening between them. Horne (2004) includes in the conditions of work such things as a quiet therapy room that is welcoming to children and will also help with the establishment of a treatment/working alliance. Lanyado and Horne write in detail in Chapter 10 in this volume about the concepts that are central to the therapeutic relationships and process: transference and countertransference, interpretation, anxiety and defence, containment, internal and external worlds.