Cultural Humility in Healthcare ________________________________________________________________
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. The considerations outlined in Table 4 require healthcare professionals to balance many different facets of patients and their lived experiences. It is especially important in treatment to adhere to these guidelines, as it sets up a therapeutic envi- ronment in which healthcare professional and patients are equal, while forcing healthcare professionals to consider the validity of various worldviews and the structural inequities that contribute to the problems and issues patients bring into therapeutic relationships.
MULTICULTURAL PERSPECTIVES IN PROVIDING HEALTHCARE 1. Provides the opportunity for two persons – from different cultural perspectives – to disagree without one being right and the other wrong. 2. Tolerates and encourages a diverse and complex perspective. 3. Allows for more than one answer to a problem and for more than one way to arrive at a solution. 4. Recognizes that a failure to understand or accept another worldview can have detrimental consequences. 5. Takes a broad view of culture by recognizing the following variables: ethnographic (ethnicity, race, nationality, religion, language usage, ability, LGBTQ status); demographic (age, gender, gender identity, place of residence); status (social, economic, educational factors); and affiliations (formal memberships, informal networks). 6. Conceives of culture as complex when we count the hundreds or perhaps even thousands of culturally learned identities and affiliations that people assume at one time or another. 7. Conceives of culture as dynamic as one of such culturally learned identities replaces another in salience. 8. Uses methods and strategies and defines goals consistent with life expectations and values. 9. Views behaviors as meaningful when they are linked to culturally-learned expectations and values. 10. Acknowledges as significant within-group differences for any particular ethnic or nationality group. 11. Recognizes that no one style of counseling – theory of school – is appropriate for all populations and situations. 12. Recognizes the part that societal structures play in patient’s lives . Note. Adapted in part from Gonzale et al., 1994. Table 4
HEALTHCARE PROFESSIONAL ROLES Culturally humble healthcare professionals need to work toward understanding themselves and their patients within the context of privilege, oppression, and marginalization. A health- care professional’s work engages patients as equal partners and addresses social inequalities and injustices on institutional and societal levels. The culturally humble healthcare professional sees their role in the provision of “therapeutic interventions” and addresses systems that serve to oppress marginalized com- munities to promote optimal well-being for patients, communi- ties, and society. The healthcare professional can fulfill many roles. Because multicultural patient care is closely linked to the values of social justice, the need for a social justice orientation in patient care is apparent (Sue & Sue, 2021). Social justice counseling is defined as “an active philosophy and approach aimed at producing conditions that allow for equal access and opportunity; reducing or eliminating disparities in education, health care, employment, and other areas that lower the quality of life for affected populations; encouraging the healthcare professional to consider micro, mezzo, and macro levels in the assessment, diagnosis, and treatment of patient and patient systems; and broadening the role of the helping professional to include not only caregiver/patient therapist but
advocate, consultant, psycho-educator, change agent, commu- nity worker, and so on” (Sue & Sue, 2021, p. 134). The social justice perspective requires healthcare professionals to assess and intervene with a perspective that balances the individual patient and the system(s) in which the patient is experiencing difficulties (Sue & Sue, 2021). The healthcare professional can act as advocate and actively speak with and, when necessary, for members of populations who are oppressed by the dominant society. These populations are confronted with institutional and societal oppression. Healthcare professionals can also be effective as “change agents” working to transform oppressive features of the institutional and societal environments. Rather than attributing patient problems to individual deficits, the healthcare professional works with the patient to identify external contributors to the problem and to remediate the consequences of oppression. Further, critical self-reflection in the context of cultural humil- ity includes analysis of power differentials and how those dif- ferentials may play out on both individual and institutional levels (Brown et al., 2021). Practicing with cultural humility suggests that healthcare professionals go beyond the confines of their offices to address differences in power and privilege that affect patients in very tangible ways.
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