Cultural Humility vs. Cultural Competence: Why the Shift Matters in Therapy
In recent years, there's been a growing conversation within therapy circles about the importance of cultural awareness. Historically, cultural competence has been the dominant framework, focusing on therapists acquiring a set of skills and knowledge to effectively work with diverse populations. However, the field is now shifting toward cultural humility, a framework that emphasizes a lifelong process of learning, self-reflection, and curiosity about clients' cultural experiences. This shift is crucial because it recognizes the complexity of cultural identity and the importance of centering the client's experience, rather than positioning the therapist as the expert on culture.
In this blog, we will explore the key differences between cultural competence and cultural humility, the limitations of the competence model, and why embracing cultural humility leads to deeper therapeutic connections and better client outcomes.
Understanding Cultural Competence
Cultural competence refers to the ability to understand, appreciate, and interact with people from cultures or belief systems different from one's own. The idea emerged from a desire to ensure therapists could work effectively with clients from diverse backgrounds, helping them avoid misunderstandings or harm. It often involves the acquisition of specific knowledge about cultural customs, values, and experiences, along with skills to interact across these differences.
In practice, cultural competence typically involves:
1. Learning about specific cultural groups: This may include understanding the history, traditions, and values of particular ethnic, racial, or cultural communities.
2. Developing specific skills: For instance, learning communication techniques or behavioral interventions that align with a client’s cultural context.
3. Adapting interventions: Making therapy more effective by considering the cultural backgrounds and needs of clients.
While these are essential aspects of therapy, the cultural competence model has some limitations that can inadvertently lead to harm, especially when it's treated as a one-time achievement rather than an ongoing process.
The Limitations of Cultural Competence
1. Static Knowledge: The traditional competence framework tends to treat culture as a set of fixed characteristics that can be learned once and then applied uniformly. This approach risks oversimplifying cultures and relying on stereotypes.
Example: A therapist who has undergone cultural competence training may learn that in some Asian cultures, it’s common to avoid eye contact as a sign of respect. However, if they apply this knowledge universally to every Asian client without considering individual differences, they may miss important cues or nuances. Not all individuals from the same cultural background follow the same norms, and assuming they do can create disconnects.
2. Power Dynamics: Cultural competence positions the therapist as the "expert" on culture after gaining sufficient knowledge. This framework doesn’t always allow space for the client to define their own experience, potentially leading to a dynamic where the therapist assumes they understand the client’s cultural identity better than the client themselves.
Example: A therapist might assume that a Black client’s reluctance to share personal information stems from cultural mistrust of mental health systems, while in reality, the client might simply need more time to feel comfortable opening up. Without checking in with the client, the therapist may reinforce power imbalances by interpreting the client’s behavior through the lens of their cultural competence training rather than individual experience.
3. Fails to Capture Intersectionality: Cultures are not monolithic. Each person’s cultural identity is shaped by many factors, including race, ethnicity, gender, socioeconomic status, sexual orientation, and more. The competence model, which often focuses on broad cultural traits, can overlook how these intersecting identities uniquely shape a client’s experience.
Example: A therapist who views a Latina woman only through the lens of her ethnicity might miss the ways in which her experiences as a single mother or as a member of the LGBTQ+ community shape her worldview. This narrow focus on a single aspect of identity can reduce the richness of the therapeutic relationship.
Shifting to Cultural Humility
Cultural humility is an approach that centers on three main pillars: lifelong learning and self-reflection, recognizing and challenging power imbalances, and institutional accountability. It moves away from seeing the therapist as a cultural expert and instead encourages a mindset of curiosity, empathy, and openness to the client’s lived experience.
1. Lifelong Learning and Self-Reflection
Unlike cultural competence, which can suggest that there's an end-point to learning about culture, cultural humility recognizes that understanding cultural identity is a lifelong journey. Therapists are encouraged to remain curious and continually reflect on their own biases, assumptions, and cultural conditioning. This involves understanding that both the therapist and the client are shaped by their cultural experiences, and that the therapist’s learning is never complete.
Example: Rather than assuming that she already understands her client’s cultural background, a therapist practicing cultural humility might ask open-ended questions like, “Can you tell me more about how your background influences how you view your mental health?” This not only allows the client to share their unique perspective but also creates space for the therapist to learn from the client’s lived experience.
2. Addressing Power Imbalances
Cultural humility encourages therapists to recognize and actively address power imbalances in the therapeutic relationship. While the therapist holds expertise in the clinical process, the client is the expert in their own life and cultural identity. A humble therapist constantly checks in with their client, ensuring the client feels empowered to express how their cultural identity shapes their experiences and therapy goals.
Example: A therapist working with a Muslim client might be aware of common religious practices, such as fasting during Ramadan, but they wouldn’t assume how the client practices their faith. Instead, they might say, “I know some of my Muslim clients fast during Ramadan, but I want to hear from you—how do you experience this time of year? How can I support you through it?” This allows the client to guide the discussion and ensures their individual experience is honored.
3. Institutional Accountability
Cultural humility also emphasizes the importance of broader, systemic change. It challenges institutions to create environments that foster cultural humility at all levels, ensuring that practices, policies, and structures support diversity and inclusion.
Example: A therapy practice might implement ongoing cultural humility training for staff, establish feedback systems for clients to report cultural insensitivity, and adjust policies that inadvertently marginalize certain groups. This institutional commitment ensures that cultural humility is embedded within the practice, rather than relying solely on individual therapists to “get it right.”
Why the Shift Matters in Therapy
Adopting cultural humility over cultural competence leads to deeper, more authentic connections with clients. Here’s why:
1. Client Empowerment: By centering the client’s cultural experience and acknowledging the limits of their own knowledge, therapists foster a more collaborative dynamic. Clients feel seen, heard, and understood, which can significantly improve therapeutic outcomes.
2. Adaptability: Cultural humility encourages therapists to remain flexible and responsive to the unique needs of each client. Rather than relying on pre-learned cultural “facts,” therapists approach each client as a new opportunity to learn and grow, leading to more individualized care.
3. Ongoing Growth: The humility model pushes therapists to continually reflect on their biases and assumptions, leading to ongoing personal and professional development. This not only benefits the therapist-client relationship but also strengthens the therapist’s overall practice.
While cultural competence has been a valuable framework for promoting awareness in therapy, the shift toward cultural humility marks an important evolution in how we approach diversity. By embracing humility, therapists can create more inclusive, respectful, and effective therapeutic environments. The move from competence to humility isn’t just about acquiring more knowledge—it’s about engaging in a lifelong process of learning, self-reflection, and open-hearted curiosity. This shift ultimately benefits both therapists and clients, paving the way for richer, more meaningful therapeutic connections.
