Culturally competent care refers to the conscious, ongoing effort that therapists can make to explore and understand cultural and subcultural values, culture-specific beliefs, and culturally-informed interventions, in order to ensure their clients get the best care possible.
Culturally competent care is both a practice and a skill. It means the therapist is taking into context not only your background, but their own background as well. They’re checking their assumptions and biases and are striving constantly to ensure they’re tailoring the therapy experience to your unique needs.
While cultural competence is often first discussed in the context of race, the idea has since been applied to many important dimensions of identity as well, including: beliefs, faiths, and religions; cultural values; linguistic needs; sexuality and gender identity; and ability.
Culturally-competent care is a nuanced concept with real, tangible impact. Below are indications of a culturally-competent therapist, warning signs that your therapist may not be culturally attentive to your needs, and tips for finding a therapist who is equipped to provide this level of care.
What is culturally competent therapy?
Culturally-competent therapists take your background into context, encourage identity-related discussions, and makes sure all of you feels welcome in therapy. The following are qualities of a culturally-competent therapist:
1. Prioritizes your unique background and upbringing, rather than imposing their own values
A culturally competent therapist knows that what's considered typical in one culture might not seem so to another, and works hard to center your background so that your worldview isn't eclipsed by their own.
Say you come from a South Asian community where it is often common for multiple generations to live together. It would be important for your therapist to understand and be aware of their biases of “healthy” relationship structures, especially if their training and upbringing valued middle-class, European-American norms of independence and the nuclear family.
A therapist who offers culturally competent care also recognizes the ways in which cultural norms, personal preferences, and experiences have shaped you. For example, if you're a person of color who has had past experiences of not being heard by white people, you may find yourself holding back from speaking about a recent experience of discrimination with your therapist who is white. A culturally-competent therapist has the skills to center your experiences, create safety, and earn your trust so that you have the space and comfort level to discuss what's on your mind.
2. Encourages you to discuss your identity and experiences – even if it feels uncomfortable at first
A culturally competent therapist doesn’t typically shy away from tougher topics, like if you're experiencing racial tension at work. They treat each topic that you bring up with due consideration and respect, and observe it within the current context as well relevant past personal and larger sociopolitical experiences.
A culturally competent therapist may discuss stereotypes with you to identify how you have had to navigate them in your everyday experiences. That said, they know not to ever reduce you to a stereotype associated with your background, or make statements that reinforce those stereotypes.
In culturally competent therapy, you are able to open up about difficult experiences and not hold back on what you want to say, when you want to say it. This trust and openness between a therapist and client, known as the therapeutic alliance, is one of the fundamental elements of successful therapy.
3. Reminds you that you are deserving of therapy
Often, individuals from marginalized backgrounds have heard or assume that “therapy is not for them." Given this, culturally competent therapists take pains to ensure you do, in fact, feel welcome in therapy, and to signal that your struggles are worth addressing.
A good therapist, but especially a culturally competent provider, makes you feel your issues are valued, worthy, and respected, especially if they've been trivialized in the past.
Culturally competent care is especially powerful because it gives you access to care that is not only welcoming, but also uniquely centered around your values, needs, and experiences. As a result, culturally competent care can be healing on a profoundly deep level – it reminds you that you and people who look and/or feel like you deserve respectful, quality care.
Signs your therapy is not culturally competent
When care is not culturally-competent, you may feel misunderstood, judged, or reduced to a stereotype. Therapy is a space for you to get the care you need, not feel like you have to conform to societal expectations.
If you’re experiencing any of the following, then the care you’re getting may not be culturally-competent:
1. You often find yourself having to explain your background in elaborate detail
If you find yourself having to constantly walk your therapist through your background and beliefs, your family's expectations, or even why you value certain attributes in a partner, then chances are, the treatment you’re receiving isn’t culturally competent.
Due to the various subtleties of how we practice our different cultures, you may have to do some explaining in sessions. But you shouldn't feel consistently obligated to explain, to the extent that you educating your therapist takes up the majority of your time together. A culturally-competent therapist will usually have enough background and knowledge to be able to keep up, and self-study on topics that are new to them, but important to you.
2. There is automatic judgement about your communication style or coping
You may feel your therapist writes off how you talk to your friends and family (or how they speak to you), without any understanding of how cultural factors and stressors may shape them.
For example, nicknames in your culture may reflect physical appearance (e.g., gordo, flaco) – and if your therapist doesn't have familiarity with this tendency, they might rush to negative judgement.
3. The provider minimizes or denies your culture-specific experiences
Rather than validating and offering thoughtful perspectives, a therapist who isn't culturally competent may shrug off your experiences of discrimination or cultural isolation.
For example, you might feel like too much or too little is expected of you at work based on your race, but your therapist subtly or explicitly negates this pattern. Or, you may be feeling misunderstood by your greater friend group due to judgements about cultural differences, but your therapist doesn't validate or try to understand this experience from your perspective.
4. The therapist struggles to discuss systemic issues
A a provider who is not culturally competent might avoid, become defensive, or even seem overly eager to discuss issues like racism, classism, heterosexism, ableism, and sizeism. If you're uncomfortable with your therapist's approach to systems of oppression in either direction, it's a red flag that something isn't working.
5. The therapist makes statements that reinforce stereotypes
A therapist who isn't culturally competent may rely on stereotypes to do work with you. For example, they might describe you using stereotypes without understanding the history behind them. This may include the seemingly positive ones, such as “you’re a strong black woman,” “you’re so inspiring,” or “you’re so eloquent.”
The above examples suggest they are not yet at the capacity at this stage of their journey to offer culturally competent care that matches your needs.
How to look for a culturally competent therapist
If you determine that your current therapist doesn’t fit your needs, or are just starting your search, here’s how to get started.
1. Look for a therapist whose specialties match your unique needs
For anyone seeking therapy, it's important to find a provider who has expertise in the areas you're struggling with now. For example, if you are frustrated by gender-related issues at home or the workplace, look for a therapist who is able to understand and offer expertise in those areas.
2. Seek someone who has worked with other clients who are like you
If you’re just starting out with your therapist, don’t be afraid to ask about what different backgrounds they’ve worked with – and if they’ve worked with other clients who are like you!
For example, if you're looking for therapy in Spanish and the therapist indicates they speak Spanish, ask them about their comfort and experience providing sessions in the language.
3. Consider what questions to ask a therapist when seeking culturally competent care
If you are looking for a culturally competent therapist, here are targeted questions to consider asking:
- I saw that you mentioned you provide culturally competent care on your website. Can you tell me more about what that means to you?
- Have you worked with other clients who share my background?
- What are your strengths as a culturally competent therapist?
- What areas do you specialize in? (e.g., religion, Asian populations, immigration etc.)
Therapy is tough work, requiring your time, dedication, and financial investment; you deserve a provider who's also done the personal and professional legwork to meet you where you're at.
Whether you’re looking to switch to a more culturally competent provider, or just starting your search for a therapist, connecting with someone who’s able to provide culturally-attentive care has the potential to make or break your therapy experience.