Cultural Sensitivity and the Therapeutic Relationship

 

The decade of my youth was the 80’s. I grew up on the lower Eastside of Erie, Pennsylvania and had the stereotypical kids on the block existence growing up.  Being an inner-city kid, I had plenty of friends who grew up in the “projects” who, other than having stories of fathers not being present or mothers who had gone to jail or being raised by grandparents, were just like me.  Except for our skin color. I had many friends in elementary school who were black and brown, of Hispanic cultural heritage. My high school years were the 90’s and with it came several refugee crisis’s including immigrants from Vietnam, Africa and the Middle East, many of whom became acquaintances and were people of color. While I had this awareness of a cultural and color difference, my own white cultural and religious orientation, seeped in racism colored my awareness until I would get to college. 

Forty-six years later, I find myself in private practice and on occasion working with someone of color/culturally different than me. At a point in time in my career, I was also a pastor and as I have come to a greater awareness of how my religion has done so much harm to the native people of this country and the many people of color we brought here, this all aggregates into a larger awareness of how privileged I am and makes cultural sensitivity all the more important.  

There have been many changes in how we address culture in the twenty-three years I have been out of college. Twenty-three years ago, homosexuality and transgender were still diagnosable mental health/ behavioral health concerns and from a religious point of view for me, a moral failing. My own diagnosis of Attention Deficit Hyperactivity Disorder was seen as a retardation all the way up to my senior year of high school. In several church communities I have served in, including the community I currently live in, racist and gender intolerance continue to have a presence. 

This begs the question, how does a white inner-city boy with two Master’s degrees possibly interact with someone of color or cultural differences? One answer that has stood out for me is a sense of vulnerability and willingness to let the client lead the session from their point of view. Secondly to this, then is to ask clarifying questions about the cultural relevance of a particular therapeutic technique or modality. Research appears to support my observations. Cultural competence in therapy involves a mental health professional understanding the beliefs, backgrounds, and values of their clients — this includes their culture, race, ethnicity, socioeconomic status, and sexuality. 

 In an article in the journal, Collegian, the authors offer that “Limited guidance exists on culturally sensitive communication related to interactions between clinicians, patients and families” (Brooks, Manias and Bloomer, 2019). Written in 2019, this article takes what is already known about cultural competence in health care: 

  • Understanding the concept of culturally sensitive communication is essential for clinicians to increase their awareness and understanding of best practice when communicating with culturally diverse patients and families. 
  • When culturally sensitive communication is used, patients are likely to experience a more positive and beneficial relationship with clinicians, and better health outcomes 

What this article’s research adds is:  

  • Ideally, the nature of culturally sensitive communication should be determined by the recipient of care, be individualized and holistic, and incorporate any cultural considerations necessary. 
  • The defining attributes of culturally sensitive communication explored and explained in this paper, aid in establishing and maintaining a trusting therapeutic relationship. 
  • This concept analysis enhances understanding of culturally sensitive communication and the benefits and challenges to its use in healthcare 

The outcome of the paper is that it shows that “By using culturally sensitive communication, patients should experience better outcomes; families should be more actively involved in healthcare, and staff should feel less emotional, with less physical and psychological distress. Further research is needed to gain an understanding of current communication and decision-making practices” (Brooks, Manias and Bloomer, 2019). 

With the different clients that I have worked with over the years who are culturally different than me, specifically those that I do not encounter in the helping profession often, (most notably, Asian, Pacific Islanders, people of Middle Eastern background and Indian), I will often try and look for culturally relevant approaches prior to the first session and in establishing rapport, confirm what is appropriate for the client moving forwards.  

Using this approach, the therapist cultivates a self-awareness of their cultural socialization and helps them begin to understand that no matter how open one may be other cultural experiences, there is a distinct difference. Secondly, this approach, which is rooted in humility, opens the door to curiosity. Curiosity for much of the work I do is often encouraged as a way to help others truly understand what is really going on with their mental health. When the therapist and client are curious together, this vulnerability can begin to break down walls and provide a path to healing. Thirdly, this approach embraces a growth mindset. When I came to private practice, I had only worked with children and youth. Being challenged to work with adults and even adults of color and of mixed cultural backgrounds helped me grow professionally and personally. It helped me truly embrace how interconnected we all are.  

The goal in culturally responsive therapy is demonstrating integration. Georgetown University’s National Center for Cultural Competency has a checklist available to self-assess the inclusiveness of your practice. 

References: 

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391. https://doi.org/10.1016/j.colegn.2018.09.007 

 

 

 

 

 

 

 

Cultural Sensitivity and the Therapeutic Relationship 

Rob Giannamore, LPC   

 

The decade of my youth was the 80’s. I grew up on the lower Eastside of Erie and had the stereotypical kids on the block existence growing up.  Being an inner-city kid, I had plenty of friends who grew up in the “projects” who, other than having stories of fathers not being present or mothers who had gone to jail or being raised by grandparents, were just like me.  Except for our skin color. I had many friends in elementary school who were black and brown, of Hispanic cultural heritage. My high school years were the 90’s and with it came several refugee crisis’s including immigrants from Vietnam, Africa and the Middle East, many of whom became acquaintances and were people of color. While I had this awareness of a cultural and color difference, my own white cultural and religious orientation, seeped in racism colored my awareness until I would get to college. 

Forty-six years later, I find myself in private practice and on occasion working with someone of color/culturally different than me. At a point in time in my career, I was also a pastor and as I have come to a greater awareness of how my religion has done so much harm to the native people of this country and the many people of color we brought here, this all aggregates into a larger awareness of how privileged I am.  

There have been many changes in how we address culture in the twenty-three years I have been out of college. Twenty-three years ago, homosexuality and transgender were still diagnosable mental health/ behavioral health concerns and from a religious point of view for me, a moral failing. My own diagnosis of Attention Deficit Hyperactivity Disorder was seen as a retardation all the way up to my senior year of high school. In several church communities I have served in, including the community I currently live in, racist and gender intolerance continue to have a presence. 

This begs the question, how does a white inner-city boy with two Master’s degrees possibly interact with someone of color or cultural differences? One answer that has stood out for me is a sense of vulnerability and willingness to let the client lead the session from their point of view. Secondly to this, then is to ask clarifying questions about the cultural relevance of a particular therapeutic technique or modality. Research appears to support my observations. Cultural competence in therapy involves a mental health professional understanding the beliefs, backgrounds, and values of their clients — this includes their culture, race, ethnicity, socioeconomic status, and sexuality. 

 In an article in the journal, Collegian, the authors offer that “Limited guidance exists on culturally sensitive communication related to interactions between clinicians, patients and families” (Brooks, Manias and Bloomer, 2019). Written in 2019, this article takes what is already known about cultural competence in health care: 

  • Understanding the concept of culturally sensitive communication is essential for clinicians to increase their awareness and understanding of best practice when communicating with culturally diverse patients and families. 
  • When culturally sensitive communication is used, patients are likely to experience a more positive and beneficial relationship with clinicians, and better health outcomes 

 

 

 

 

What this article’s research adds is:  

  • Ideally, the nature of culturally sensitive communication should be determined by the recipient of care, be individualized and holistic, and incorporate any cultural considerations necessary. 
  • The defining attributes of culturally sensitive communication explored and explained in this paper, aid in establishing and maintaining a trusting therapeutic relationship. 
  • This concept analysis enhances understanding of culturally sensitive communication and the benefits and challenges to its use in healthcare 

The outcome of the paper is that it shows that “By using culturally sensitive communication, patients should experience better outcomes; families should be more actively involved in healthcare, and staff should feel less emotional, with less physical and psychological distress. Further research is needed to gain an understanding of current communication and decision-making practices” (Brooks, Manias and Bloomer, 2019). 

With the different clients that I have worked with over the years who are culturally different than me, specifically those that I do not encounter in the helping profession often, (most notably, Asian, Pacific Islanders, people of Middle Eastern background and Indian), I will often try and look for culturally relevant approaches prior to the first session and in establishing rapport, confirm what is appropriate for the client moving forwards.  

 

 

 

Using this approach, the therapist cultivates a self-awareness of their cultural socialization and helps them begin to understand that no matter how open one may be other cultural experiences, there is a distinct difference. Secondly, this approach, which is rooted in humility, opens the door to curiosity. Curiosity for much of the work I do is often encouraged as a way to help others truly understand what is really going on with their mental health. When the therapist and client are curious together, this vulnerability can begin to break down walls and provide a path to healing. Thirdly, this approach embraces a growth mindset. When I came to private practice, I had only worked with children and youth. Being challenged to work with adults and even adults of color and of mixed cultural backgrounds helped me grow professionally and personally. It helped me truly embrace how interconnected we all are.  

The goal in culturally responsive therapy is demonstrating integration. Georgetown University’s National Center for Cultural Competency has a checklist available to self-assess the inclusiveness of your practice. 

References: 

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391. https://doi.org/10.1016/j.colegn.2018.09.007 

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s