Working towards cultural competence in therapy

By Fabiana Franco, Ph.D
April 18th, 2020

Cultural differences in therapyFor the therapist, cultural competence is the ability to provide therapy than can overcome cultural barriers that exist between the patient and the therapist. The more a therapist knows about a patient’s culture, the more likely that person will feel comfortable.

In a world where therapists and clients shared homogenous backgrounds, cultural competency would not be an issue. For therapists practicing today in the United States, however, this is not the case.

According to the U.S. census, 23.5 percent of the population identifies as non-white and 13.4 percent are foreign-born. The United States is home to people who come from all over the world, and most therapists will see clients from many different cultures.

Cultural Openness or Cultural Knowledge?

In an ideal world, every therapist would have a deep knowledge of every patient’s culture. However, acquiring enough knowledge to become culturally aware and competent for every client is impossible. It takes years to fully understand another culture and, even then, looking at another culture through our own eyes is highly problematic and limiting.

Cultural openness can be a complement to cultural knowledge. With openness, sensitivity and self-awareness the therapist can form therapeutic relationships with clients who have very different personal histories and backgrounds. Seen in this way, cultural openness, awareness, desire, and sensitivity join knowledge as the building blocks of cultural competence. (4)

Steps to Cultivate Openness and Overcome Biases

Step 1: Understand Your Own Culture

For any therapist, understanding one’s own culture is the first step on the road to fully comprehend the impact of culture on how you perceive others. For example, it can be difficult for a person raised in an individualistic society to understand those coming from a collectivist society.

In the United States, we are taught to believe it is our birthright to pursue personal happiness over the good of the whole and we don’t stop to consider how strange this may look to members of other cultures.

Step 2: Keep it Simple, Keep it Individual

Remember, in our work as therapists we are dealing with individuals, not stereotypes and races (2). In therapy, we are listening to patients and working to empathize and understand their experience as well as their own perceptions of their experience. It is from this space that we work, we are never trying to impose our own view of what’s right on our clients.

Step 3: Focus on the Relationship

The therapeutic relationship is an alliance between the therapist and the client. The fact that the therapist and client are from different cultures may actually foster a closeness that would not otherwise be present if both shared the same culture.

In this way, the cultural differences can help the therapist avoid being boxed in by the very social norms and values with which the client may be struggling. Rather than be a detriment to the relationship, the client can benefit from a point of view that is different and free from potential judgments regarding the behavior, wants, needs, and desires that may conflict with social norms.

What Therapists Need to Remember

Over any therapist’s career, working with patients of different cultures is guaranteed. The therapist can enhance the therapeutic experience by cultivating openness towards each client’s culture, as well as learning about the person’s culture.

To provide quality care, the therapist must first be honest about his or her ability to provide therapy to any individual client. In addition to cultural awareness and competence, the issue of language competency is important and can determine whether a client continues therapy or not (3).

If a therapist does not feel qualified to provide adequate therapy, steps should be taken to point the patient in the right direction so he or she can get the help they need.


1. U.S. Census Bureau. Quick Facts, People. Retrieved from
2. Howard, G. S. (1991). Culture tales: A narrative approach to thinking, cross-cultural psychology, and psychotherapy. American psychologist, 46(3), 187.
3. Suarez-Morales, L., Martino, S., Bedregal, L., McCabe, B. E., Cuzmar, I. Y., Paris, M., … & Szapocznik, J. (2010). Do therapist cultural characteristics influence the outcome of substance abuse treatment for Spanish-speaking adults?. Cultural Diversity and Ethnic Minority Psychology, 16(2), 199.
4. Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: a concept analysis. Health & social care in the community, 26(4), 590-603.

Posted in Articles | Comments Off on Working towards cultural competence in therapy

Comments are closed.

Powered By MemberPress WooCommerce Plus Integration