The professions share some commonalities within their guidelines for culturally sensitive practice. Counseling professionals agree that counselors must continually develop an understanding of their clients’ diversity and commit to lifelong learning. The counseling, psychology, and social work professions have been exploring the cultural humility approach, as evidenced by their professional organizations’ recent publications and public information (APA, 2017; NASW, 2015; Ratts et al., 2015). How to Develop Cultural Humility Self-awareness is central to cultural humility; how a person is informs how they see another. Awareness may stem from self-reflective questions such as the following: ● Which parts of my identity am I aware of? Which are most salient? ● Which parts of my identity are privileged and/or marginalized? ● How does my sense of identity shift based on context and settings? ● What are the parts onto which people project? Moreover, which parts are received well, and by whom? ● What might be my own blind spots and biases? With this awareness, a provider can ask how they receive the patient: Who is this person, and how do I make sense of them? What knowledge and awareness do I have about their culture? What thoughts and feelings emerge from me about them? A provider operating with cultural humility must listen with interest and curiosity, be aware of their own possible biases, and attempt a nonjudgmental stance about what they hear, recognize their inherent status of privilege as a provider, and be willing to be taught by their patients. One challenge for providers is that healthcare executives, providers, and others working in the system are not having honest, authentic conversations about systemic or individual biases because it makes them uncomfortable. Everyone has biases. Avoiding or concealing them only escalates the problem. Instead, healthcare institutions and providers need to raise them to the surface and become more comfortable with having uncomfortable conversations to effect change. Cultural Humility in Therapy Using the principles of cultural humility, therapists should explore the various ways in which healing might take place for the client, which may mean broadening the scope of the therapeutic frame. This could include working alongside a translator rather than expecting a refugee client to communicate solely in English or meeting with refugee families at a location they know and trust (e.g., community agency, school, refugee resettlement office) rather than expecting them to come to the therapist’s office (Captari et al, 2021). Tips for Practicing Cultural Competence and Cultural Humility ● If you, as the counselor, are a person of color, consider how that affects your practice and work with diverse patients. If you are White, reflect on the implicit biases Final Thoughts on Cultural Humility A culturally humble approach is interactive, with counselors having an openness and willingness to learn. It is the acceptance that the counselors may have expertise in the psychological aspects of the patient’s care, but the patient/family has the expertise in their own health. Cultural humility is about accepting our limitations and increasing our self-awareness of our biases and misperceptions. It is
Self-Assessment Question 5 Which of the following statements pertains to the definition of cultural humility? a. Healthcare professionals must learn a quantifiable set of attitudes. b. Cultural humility is an ongoing process. c. Cultural humility is a skill that can be taught. d. Healthcare professionals know that there is an end point to cultural humility. ● Do not assume. Ask the patient about background, practices, religion, and culture to avoid stereotyping. ● Pay attention to office practices: Do they enhance an atmosphere of welcoming everyone? Are interpreter services available, if needed? ● Ask patients by what pronouns they would prefer to be addressed. that may affect your practice with diverse patients and theirs with you. ● Use open-ended questions such as “What do you believe the problem is?” Asking questions as a way to understand and appreciate the patient’s perspective regarding their illness is vital. We become learners when we listen to the patient’s story and join alongside the patient to provide care. ● Develop a culture of feedback, beginning with the first session and continuing throughout. Although clients are not responsible for teaching counselors about their cultural identities, counselors cannot possibly understand how culture influences a particular client. A general example of creating a culture of feedback is as follows: “I need to make sure that I understand your perspective in our sessions. For instance, although I know some things about your cultural background, I may not fully understand how this impacts your life and relates to challenges that have brought you to counseling. I welcome your thoughts about anything you think I may not be getting in our sessions about you, your values, or your cultural experiences. I welcome your feedback.” ● For ongoing self-reflection, use a journal to jot down potential implicit biases and observations about rapport building. ● Inquire about what the patient felt would be helpful. Are there cultural practices or herbal remedies that they have already tried, and what was the result? Do religious, cultural, or individual convictions affect the treatment choice? ● After the session, ask the patient if he or she felt understood, if he or she understands the process, and if there is anything else he or she would like to add to be better understood. ● Be an advocate. Recognize that your advocacy and allyship can help transform culture and norms in the workplace. Open a dialogue if you notice a practice or policy excluding cultural groups. about committing to lifelong learning, self-reflection, and the willingness to learn from our patients about what is important to them and collaborating with them for the best possible care.
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Book Code: PCTX1325
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