Many minorities, when faced with systemic oppression, feel pressured to present themselves in a way that they feel is expected of them. They might avoid certain topics because they expect others will not “get it.”

Sometimes these patterns may come up in therapy as well, particularly if clients are concerned their therapists may not understand. Therapists who provide culturally competent care are particularly aware of different world views, including their own biases, and have the skills to tailor therapy to each client’s unique needs. As a result, clients are able to more fully discuss the values, experiences, and parts of their identity that matter and, over time, make informed decisions towards restoring and protecting their mental health. Here’s how culturally competent care is defined and what it looks like in treatment.

What is culturally competent care?

Definition of culturally competent care

The most popular understanding of culturally competent care is derived from the works of Dr. Derald Sue, a renowned counseling psychologist and pioneer in the field of cultural competence in clinical settings.

This definition highlights three critical components that providers adhere to through consistent and active engagement:

  1. Build self-awareness of own worldview and biases: Therapists must invest in building their self-awareness of their own worldview, biases, limitations, and preconceived notions they bring into the therapy room
  2. Expand knowledge of different worldviews: Therapists must consistently strengthen their knowledge of the existence of different world views and factors that shape them, without negative judgment
  3. Develop skills to tailor to individual clients’ needs: Therapists must develop appropriate skills and strategies, so that they can tailor appropriate and relevant interventions to the needs, worldviews, and values of their clients

Cultural competence is a process, not an outcome, which means that therapists are continuously working on their blindspots, awareness, skills, and knowledge. The learning never stops :)

Identities that cultural competence applies to

While cultural competence was often first discussed in the context of race, the idea has since been applied to many important identities as well, including:

  • Beliefs, faiths, and religions
  • Cultural values
  • Linguistic needs
  • Behaviors
  • Sexuality and gender identity

How culturally competent care affects treatment

The provider takes culture into context

Culturally competent care centers your definitions of what might be healthy by prioritizing the values, identities, and goals that matter to you.

For example, if a South Asian client who comes from a community where it is often common for multiple generations to live together, it would be important for their therapist to understand their own biases of “healthy,” especially if their training and upbringing valued middle class European American norms of independence and the focus on the nuclear family.

The provider demonstrates to the client that they are worthy of care

Culturally competent care can be healing on a really deep level – it reminds you that you and people who look and/or feel like you deserve thoughtful care.

Often, discriminated individuals have assumed that “therapy is not for them” so it is really powerful when you have access to care that centers your values, needs, and experiences.

When care is not culturally competent

Examples of care that isn’t culturally competent

  • When your provider minimizes or denies your culture-specific experiences
  • When there is negative judgement about your communication style or coping without any understanding of how cultural factors and stressors may shape them
  • If you find that you often have to explain your background in much detail, it suggests that your therapist may not be well informed at least on the knowledge, and possibly the skillset, component of cultural competence
  • If statements are made that are reinforcing stereotypes, including the seemingly “positive” ones (“You’re a strong Black woman,” “You’re so smart,” “You’re so inspiring”)
  • If you find that the work seems to be about getting you to fit the intervention rather than the interventions fitting you
  • If your therapist struggles to discuss systemic issues such as racism, classism, heterosexism, ableism, and sizeism by avoiding, being defensive, or even overly eager, it might suggest that they may not have the capacity at this stage of their journey to offer cultural competent care that matches your needs.

Click here to learn how to discuss cultural competent care with your current or potential therapist!

Much of this article was originally published on Zencare.co, a wonderful resource that makes finding a therapist a lot easier. Thanks for the opportunity, Zencare!