Latine individuals' and their therapists' perceptions on therapy in health care settings: a critical autoethnography using an assemblage methodology grounded in Latina feminist thought

This critical autoethnographic study examines therapeutic relationships between Latine individuals and their therapists within U.S. health care systems. Guided by Latina feminism and assemblage theory, I entered the research from within the very systems I sought to understand, as a music therapist, union delegate, and first-generation Salvadoran American woman. Drawing on dialogic interviews, journals, field notes, and reflexive writing, I examined how social, political, economic, and institutional forces shape therapy and health care and how power circulates through both practice and research. Through this process, therapy and research emerged as overlapping assemblages marked by care, control, and ongoing negotiation. The work highlights how gatekeeping, bureaucracy, and economic structures influence access, legitimacy, and the conditions of care. The findings emerge through research compositions that map how mistrust, recognition, cultural proximity, and surveillance move through and between therapy, research, and institutional life. Within these assemblages, small gestures of humor, ritual, and shared language created fragile spaces of safety and connection. This study reframes therapy as a living assemblage in which care and power are continually reconfigured. It extends theory by showing how assemblage and Latina feminism together offer a way to understand therapy and research as fluid, relational, and politically situated. Emerging concepts of critical witnessing and the negotiation of safety highlight how participants and therapists navigate recognition, mistrust, and institutional constraint. These insights advance liberatory approaches to music therapy and health care grounded in culture, relational accountability, and ethics of care.