The question of representing and interpreting `psychological distress' or `subjective distress' is one of the most dif®cult to measure and least understood variables in psychotherapy (Barkham et al., 1996). As a result it continues to generate much of the research in this area (see, for example, Aveline and Shapiro, 1995; Dryden, 1996; Roth and Fonagy, 1996; Toukmanian and Rennie, 1992), but the focus seems to be con®ned to mainstream patients' groups; with ethnic minority patients appearing to be under-researched, and some of the major `issues' concerning this patient group tend to be untheorized (Moodley, 2000).