Across all mental and behavioral health workers nearly 70% are White, whereas 22% are Black and 13% are Hispanic or Latinx; the remaining mental and behavioral health workers are Native American or Asian. Most counselors are also from middle-class backgrounds, are without disability, and identify as heterosexual and cisgendered. Although the perspective of this course is influenced by the author’s own unique facets of diversity (e.g., White, heterosexual, cisgender, middle class, female, and currently nondisabled), it is likely that clinicians of various backgrounds will benefit from the course and be able to apply the content to their practices. Additionally, it is important to note that the term White , rather than Caucasian , is intentionally used in this course to reflect the view that race is socially constructed and that interactions among people of diverse backgrounds are embedded within structured and inequitable social relations. These inequities in social relations reflect a society
structured on White supremacy that serves as a foundation for the continued social and economic disparities existing between White people and people of color living in the same society. The status, power, and inclusion of whiteness within American culture are often unspoken and affect how individuals of differing backgrounds and identifications interact. The term White is used to reflect a concept of identity, rather than biological ancestry Bonds & Inwood, 2016). Similarly, the term cisgender female is used rather than simply female to illustrate both the invisibility and oppression of transgender individuals. This course presents an introduction to cultural humility and offers tools for social workers, mental health counselors, marriage and family therapists, and psychologists to use in working with diverse clients in a culturally humble manner.
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. 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
An important part of cultural humility is identifying one’s own biases, self-understanding, and interpersonal sensitivity. 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.
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).
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Book Code: SWUS1525
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