DEFINITION OF CULTURAL HUMILITY
In the context of mental and behavioral healthcare services, cultural humility is defined as “a process of being aware of how people’s culture can impact their health behaviors and, in turn, using this awareness to cultivate sensitive approaches in treating patients” (Prasad et al., 2016). In contrast, cultural competency is described as ensuring that all healthcare professionals learn a quantifiable set of attitudes that allow them to work effectively within the cultural context of each patient. There is an endpoint to cultural competency. It ends with the termination of the mental and behavioral healthcare professional–patient relationship. On the other hand, cultural humility is an ongoing process, which requires continual self-reflection and self-critique. Cultural humility is a prerequisite to cultural competency. It forms a basis for effective, harmonious healthcare professional–patient relationships (Prasad, 2016). Cultural humility involves entering into a professional relationship with a patient by honoring the patient’s beliefs, customs, and values. Cultural competency is described as a skill that can be taught, trained, and achieved. This approach is based on the concept that the greater the knowledge a healthcare professional has about another culture, the greater their competence in practice. Cultural humility de-emphasizes cultural knowledge and competency, focusing instead on lifelong nurturing of self-reflection and self-critique, promoting interpersonal sensitivity, addressing power imbalances, and promoting the appreciation of intracultural variation and individuality (Stubbe, 2020). This humility exemplifies respect for human dignity. An important part of cultural humility is identifying one’s own biases, self-understanding, and interpersonal sensitivity. Definitions Diversity is a multidimensional concept that refers to many aspects of an individual that combine to comprise an overall sense of self. Moreover, diversity occurs within a cultural and social context where variances within the general population are treated differently based on the social, political, and cultural constructs existing within a society. Some dimensions of diversity include race, socioeconomic class, gender, sexual orientation (i.e., identifying as lesbian, gay, bisexual, queer/questioning [LGBQ]), gender identification (i.e., identifying as transgender), and disability. Although this is not an exhaustive list of all elements of individual diversity, it does address many prominent dimensions of diversity an individual may have as well as determine where that individual falls within the societal hierarchy. Dimensions of diversity also serve to privilege and empower some members of society while oppressing and marginalizing other members of society (Sue & Sue, 2021). Counselors need to understand the effects of diversity on a client in multiple domains, including a client’s mental and behavioral health and well-being. In some instances, a client’s identity constructs may be a source of great strength, and in other contexts they may contribute to increased stress. For example, on a microlevel simply being different in any way increases the threat of victimization and bullying (Menesini & Salmivalli, 2017). When individuals differ from the majority group, they are at risk of victimization. For instance, being the only individual in a school, workplace, or community group who possesses a certain trait increases the risk of victimization, regardless of what that trait may be (e.g., race, religion, socioeconomic status, LGBTQ, appearance). Children with special needs and physical disabilities are consistently at an increased risk of victimization (Malecki et al., 2020). Adults who are members of a minority group suffer from higher rates of bullying (Lewis et al., 2011). Some minority workers have been shown to endure a bullying rate that is two to three times higher than that of their nonminority coworkers (Lewis et al., 2011). Namie, Christensen, and Phillips (2014)
It is important that all healthcare professionals nurture an appreciation for the many facets of each patient, including culture, gender, race, ethnicity, religion, sexual identity, and lifestyle. According to Yancu and Farmer (2017), healthcare professionals need both process (cultural humility) and product (cultural competence) to effectively provide care and interact with a culturally diverse society. Healthcare Consideration: A culturally humble healthcare professional needs to be able to provide services that transcend culture, ability, LGBTQ status, and class, as well as integrate healthcare professional–stated cultural and other considerations into treatment. Moreover, the healthcare professional must recognize the roles that power, privilege, and oppression play in both the counseling relationship and patient experiences (Sue & Sue, 2021). Self-Assessment Quiz Question #1 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.
DIMENSIONS OF DIVERSITY IN THE U.S.
found that Hispanic Americans, African Americans, and Asian Americans all experienced higher rates of workplace bullying, both witnessing and targeting, than White Americans and that their individual group rates were each higher than the national average. In the workplace, as in school settings, differences of any type increase a person’s risk of being bullied or experiencing other forms of victimization. For decades, “social psychologists have repeatedly demonstrated that individuals who do not belong to the group are devalued” and that they are more likely to be used as scapegoats in the workplace (Zapf & Einarsen, 2011, p. 188). Being a victim of bullying and other oppression results in a much greater likelihood of depression and posttraumatic stress disorder (PTSD) in adolescents (Kosciw et al., 2020; Schuster & Bogart, 2013). Adult victims of workplace bullying, or community oppression, will show signs of stress and trauma (Hogh et al., 2011). The inability to concentrate, insomnia, mood swings, anxiety, depression, and physical symptoms eventually cause impairment at school and work, resulting in increased rates of absenteeism or presenteeism (being present at work but unable to function optimally; Einarsen et al., 2011; Lutgen-Sandvik & Arsht, 2014). As such, the context of a client’s diversity elements may have a direct effect on the client’s reasons for presenting to counseling in the first place. Intersectionality is a concept that is used to describe how these various dimensions come together to privilege or oppress individuals and groups of individuals. Intersectionality is defined as “multiple, intersecting identities and ascribed social positions (e.g., race, gender, sexual identity, class) along with associated power dynamics, as people are at the same time members of many different social groups and have unique experiences with privilege and disadvantage because of those intersections” (Rosenthal, 2016, p. 475). Each individual has a multitude of diverse identities; some are visible and some are not readily identifiable. Each of the identities intersects with the other identities.
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Book Code: PYFL4024
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