________________________________________________________________ Cultural Humility in Healthcare
ASSESSMENT AND TREATMENT It is important for healthcare professionals to approach every individual patient with a cognizance of the possible various intersecting identities within the patient, but without a ste- reotype of the patient based on preconceived notions of these intersecting identities (e.g., race, ethnicity, LGBTQ status). Implementing the practice of cultural humility may flummox healthcare professionals as they approach patients in a clinical setting (Schildkraut, 2017). The following example from Wyatt (n.d.) illuminates some key elements of providing patient care with cultural humility. An interracial couple, an African American father and a White mother, come into therapy because their child was kicked out of school for fighting and the father was called into child protective services for spanking his child. When they entered the office, the father was very angry and the mother was getting extremely upset, trying to calm him down. The White therapist suggested meeting with the father alone first. When he met with the father, rather than trying to silence his rage, he joined with him by stating, “It sounds like you’re furious with the situation that’s happened; you’re tired of it.” The father was able to calm down at that point, as the White therapist was allowing him to be angry in his presence and was acknowledg- ing that there might be a reason for anger. The therapist then asked the father if his disciplining method had anything to do with wanting to protect his child. The father responded that, yes, he was afraid his child, “a Black kid,” was at risk of going to prison if he was fighting at school. The father did not want that for his child and was frightened. By providing room for the father to express his rage and his fear, the therapist was able to make the clinical session more meaningful. Healthcare professionals who practice cultural humility also recognize that assessment tools and treatment protocols may not be appropriate for all patients. Historically, many therapeu- tic strategies employed in patient care were developed without empirically supported research with ethnic minorities (Sue & Sue, 2021). However, healthcare professionals should not rely solely on manualized treatment protocols to guide their inter- ventions, as such an approach can fail to appreciate patients’ unique experiences and the effect of differing social environ- ments. Rather, when employing a research-based therapeutic practice, healthcare professionals should adapt the approach in accordance with the patients’ values, experiences, and prefer- ences while understanding the influence of the broader societal context (Brown et al., 2021). Through facilitating a respectful partnership that allows patients to take the lead in narrating their experiences and in identifying personal treatment goals, healthcare professionals can create an environment that appre- ciates patients’ perspectives. Table 4 outlines the important aspects of the multicultural perspective in clinical settings.
Cultural humility requires self-reflection and taking risks, discovering new information, and using patients and others as resources (Brown et al., 2021). Culturally humble learners understand that they will both make mistakes and learn from those mistakes because, as healthcare professionals, they are in a constant state of becoming. Lifelong learning allows the healthcare professional to integrate shifting paradigms and embark on continual reflection and reeducation regarding dominant perspectives on marginalized populations and communities (Brown et al., 2021). Finally, it requires that healthcare professionals separate themselves from thinking about patients from a deficit perspective and instead think of patients as fellow humans with rich intellectual, cultural, ethnic, and class backgrounds and with a myriad of strengths (Brown et al., 2021). Recognizing and reflecting on one’s own possible biases, religious values, and family values may help to limit the influence of those biases on their patient interactions. WHITE IDENTITY White identity theory was first developed by Helms in the 1980s and 1990s as a tool for White healthcare professionals to “create meaning about their identities as Caucasians, par- ticularly in terms of how they think about, respond to, react to and interact with patients from different racial/ethnic groups” (Chung & Bemak, 2012, p. 67). In other words, the theory’s formation was based on the idea that White people are so immersed in the dominant culture that they are unaware of the influence of the dominant culture’s ethnocentric images and ideals. Being White makes it easier to assimilate into the dominant culture and to partake in unearned privileges many White people enjoy but do not acknowledge. Most White people perceive themselves as unbiased, but such self- perception may truly impede one from taking responsibility for one’s own prejudices (Sue & Sue, 2021). White healthcare professionals have a special responsibility to understand their own privileges, biases, racism, and discrimination so that they may develop a positive relationship within counseling sessions. Healthcare Professional Consideration National surveys do not have a historical track record of asking White people meaningful questions about their racial identity (Schildkraut, 2017). Healthcare profession- als should promote research that includes questions about racial identity. Self-Assessment Question 8. When exploring one’s own beliefs about White identify, it is important to acknowledge that: A) Most White people perceive themselves as biased. B) White identity theory was first developed to discount the idea that White identity exists. C) National surveys often ask White people questions about their racial identity. D) Being White makes it easier to assimilate into the dominant culture.
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