Culturally-Sensitive Therapy

One of my passions in the last four years was teaching a summer graduate-level course on race, culture, and privilege for therapists in training in Brooklyn, New York. I have had the honor of teaching dozens of students from various backgrounds in becoming more culturally sensitive, self-aware, and clinically knowledgeable in how they view and understand their clients. I have found that the ability to provide culturally-sensitive therapy is imperative to, and often indicative of, successful treatment -- no matter what style or type of psychotherapy is being offered.

So what exactly is culturally-sensitive therapy? To unpack this term requires an understanding of the word “culture”. Culture encompasses a wide range of descriptors, including one’s dress, language, religion, customs, sexuality, food, laws, mannerisms, and beliefs. We attain our values from our cultures, which then influences norms and practices, including psychological processes. Ultimately, culture influences how people express themselves, seek help, address emotional and psychological stress, and develop social support. Most times, the adaptation of culture is not explicitly taught but is implicitly absorbed over time. In short, culture is the lens in which we see the world; it is the air that we breathe. Keep in mind though, no person shares the same lens or breathes exactly the same air.

Culturally-sensitive therapy, then, is a holistic approach which acknowledges that all individuals are cultural beings and have a cultural, ethnic, and racial heritage. Therapy that is culturally-sensitive reflects a therapist’s ability to understand and utilize within treatment the strengths and background of the client in front of them. It is therapy that contextualizes the client within historical and present-day individual and collective experiences with power, oppression, and privilege. This is especially relevant in today’s political climate. Just looking at the news headlines from the last few months (or weeks), it may be a particularly heightened and anxious time for people who identify with an immigration status, or as a sexual minority, or with a hidden disability, or as a survivor of gender-based violence, or as a person living paycheck to paycheck, and so forth – as a culturally-sensitive therapist, these identities should matter greatly in conceptualizing and treating a client.

A common pitfall for new therapists is thinking that they cannot be (as) effective if they do not share some core cultural identities with their patients. From my experience training graduate students and postdoc fellows, and also from the myriad of patients I’ve seen myself as a clinician, I don’t believe that a therapist needs to identify with the same culture as their client (whether it be the same ethnicity/race, sexuality, gender, belief system, politics, etc.) to be effective with that client. Can it help? Certainly. More importantly, though, is that inherent in culturally-sensitive therapy is the ability for a therapist to practice cultural humility – to know that one doesn’t know everything, that one holds certain (mis)assumptions and biases, yet one is keenly aware of societal, structural, and institutional powers and systems that advantage some while disadvantaging others. This therapist is able to step out of themselves and their own personal worldview and step into their client’s worldview, holding space and time to center the client’s cultural identities, while recognizing potentially differing views as both valid and valuable. The onus should never be on the client to teach the therapist about their culture, but for the therapist to constantly examine their own biases, to continue expanding their knowledge of diverse groups of people within context, and to practice skillful interventions that are culturally appropriate.

 Every person belongs to multiple cultural groups, making each individual a blend of many influences. It is often at the intersection of these identities where healing happens. I plan to write more posts in the next few months to give more clinical examples of culturally-sensitive therapy.