Therapists who encourage clients to think primarily about others' expectations are especially likely to experience difficulty developing a strong therapeutic alliance with clients who

I believe the answer is: Individualism
People with individualistic value would most likely place the things that benefit them the most as the utmost priority.
Even though this may help them become independent, it often would make them disensitized with the needs of other and would often went out of their way to avoid socializing with other people.

Americans often speak of their country as one of several large regions.  these regions are cultural units rather than governmental units --  formed by history and geography and shaped by the economics, literature and folkways that all the parts of a region share. what makes one region different from another? a region's multicultural heritage as well as distinct demographic characteristics like age and occupation make regions different and special. within several regions, language is used differently and there are strong dialects. there are also differences in outlook and attitude based on geography.