When Linda returns to counseling several weeks later, she again admits to not following through on Janine’s suggestions. She is still stressed. Janine is frustrated at the lack of progress but continues to try to help Linda with her stress through offering a variety of self-care options. Linda continues to agree to try a variety of techniques and agrees to continue to meet, but with little enthusiasm. Questions 1. What cultural forces might have affected Linda and Janine’s interactions? 2. How might Janine have explored Linda’s stress more comprehensively? 3. How did the therapy techniques reflect a middle-class perspective? 4. If you were the nurse practitioner, what would you do? Why? Discussion It is not surprising that Linda sought help from the clinic doctor first because her poverty likely afforded her little opportunity to seek therapy. Fortunately, the clinic she went
to had counseling services available and Linda was able to meet with a therapist. Although Janine is empathetic and caring, she fails to make headway with Linda’s stress and is frustrated by Linda’s lack of follow-through. Janine neglects to thoroughly explore the role that poverty plays, both in Linda’s stress response and in her ability to pursue stress reduction in the way that someone with more resources might be able to. Linda does not have the luxury of time, and smoking provides her quick relief. Although Linda may want to stop smoking, it is unlikely that she has the time to devote to smoking-cessation classes. Janine might have wanted to work with Linda on some of the stressors in her life that require advocacy outside the office. For example, Linda’s inadequate diet may be the result of not being able to afford enough food. Janine could have explored this with Linda and helped her access various governmental and nonprofit programs to help her obtain sufficient food. Although Linda agreed to continue to work with Janine, she may have done so because she does not feel that she had an option.
CONCLUSION
When working with patients from diverse backgrounds, healthcare professionals must be willing to continuously look at personal dimensions of diversity and at how those dimensions affect their worldview and their view of their patients. Thus, mental and behavioral health professionals enter the professional relationship with a solid base of self-knowledge and a continuous commitment to critical self-reflection. They also enter into patient interactions with an open mind and curiosity regarding their patients’ lived experience, and they do not pretend to know or understand each patient’s unique combination of facets of diversity and do not assume that the patient will behave or believe in any particular way based on those facets of diversity. In fact, the culturally humble healthcare professional “cultivate(s) openness to the other person by regulating one’s natural tendency to view one’s beliefs, values, and worldview as superior, indeed, the culturally humble healthcare professional strives to cultivate a growing awareness that one is inevitably limited in knowledge and understanding of patients’ backgrounds” (Hook et al., 2016, p. 152). This stance of openness and equality provides an environment for healthcare professionals to enter into Resources ● Cultural Humility: People, Principles, Practices https://www.youtube.com/watch?v=_Mbu8bvKb_U&list =PL879555ABCCED8B50 ● National Center for Cultural Competence https://nccc.georgetown.edu ● Project Implicit https://implicit.harvard.edu/implicit/aboutus.html
respectful and equitable partnerships with patients. Moreover, the culturally humble clinician considers how societal structures in the U.S. serve to oppress some individuals and groups while empowering other individuals and groups. Patients are affected by the inequality within the U.S. They are affected by living in a society where racism, sexism, classism, homophobia, and discrimination based on a variety of other diverse identities, including disability and gender identity, are expressed in a multitude of ways. This discrimination obstructs access to resources and opportunities and impedes interpersonal relationships. The power imbalances within society and institutions that are experienced by patients require the culturally humble healthcare professional to take an active role in correcting those imbalances. Cultural humility challenges healthcare professionals to ask difficult questions and encourages them not to reduce patients to a preconceived set of cultural norms that have been learned in trainings about diversity and difference (Foronda et al., 2016). Finally, the culturally humble healthcare professional will engage in lifelong learning that supports effective practice.
● The Office of Minority Health, U.S. Department of Health and Human Services https://minorityhealth.hhs.gov ● Think Cultural Health https://www.thinkculturalhealth.hhs.gov
WORKS CITED https://uqr.to/CulturalHumilityinBH
Book Code: SWUS1525
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