What’s culture got to do with it? People are more than their skin tone…we are individuals, we are representatives of our families, communities, race, ethnicity and heritage. When seeking a culturally competent therapist these are the factors they should take into consideration. Some important points to consider include whether the prospective therapist understands the difference between cultural awareness and cultural sensitivity and understands the difference between culture and ethnicity. Culture and ethnicity complement each other, but are distinctly different. Culturally competent therapists look at the individual, the individual’s family and the society at large in which they live. They will ask questions to explore the connection between these three aspects of your being and the impact it makes on your behavior, your interactions and your thoughts.

      As the person seeking a culturally competent therapist, what does this all mean? Well, just keep reading and it will all become clear. Here’s a scenario to consider…You are an African-American female who lives in the tri-state area. You enjoy activities like ice-skating and skiing. You prefer the cold air of New England and the charm of B&Bs when you travel instead of the warm breezes of the Caribbean. People use the terms culture and ethnicity with different intended meanings. Culture includes but is not limited to ethnicity, gender and social class. Culture is a much broader concept that can also incorporate religion, region, hobbies and social networks. It is a body of learned behaviors, traditions and rituals constructed by a society of people. When thinking of the African American female, a culturally incompetent therapist may look into her lifestyle or interests as a way of attempting to assimilate to mainstream society, which comes across as somewhat pathologizing. If this woman were looking for a culturally competent therapist, she might ask the therapist some of the following questions:

1. Do you feel people of different cultures or lifestyles are now free to live to their lives without judgment?
2. How do you take time out to learn about culture?
3. What is your definition of culture?
4. Do you feel socio-economic difference or race makes more of a difference in our society? Why?
5. What’s your stand on the melting pot concept?
6. Are there cultural boundaries for people? How are these boundaries defined? What happens when they are crossed?

      These are key concepts and ideas that a culturally competent therapist will be ready, open and able to answer. A culturally competent therapist will understand that cultural awareness occurs when a person is open to learning a wealth of facts or at least a foundation of knowledge about the specifics of a group. They will understand that the facts or knowledge gained is NOT necessarily all inclusive nor does it represent each person within that group. They are aware that multiple factors impact the cultural composition of a person. To this point, a culturally competent therapist may ask questions to you during therapy sessions such as:

1. What is your cultural makeup? How do you identify or define yourself? Obviously there are categories on given assessments but in attempting to be culturally competent and sensitive, the therapist will understand that you are more than the simplistic categories typically made available on standard assessments and they will explore what that means for you.
2. Are your rituals or traditions culturally based? Often times, when clients discuss behaviors or interactions there is a possibility that the information will across as foreign or even strange to the therapist. This can translate itself into a pathology for the therapist, when the behavior may not pathological in nature. Culturally competent and sensitive therapists will not take you’re your words at face value. They will explore the origin of these behaviors, they will explore whether this a norm for your culture. 

     It is important to understand that Cultural Sensitivity entails responding to cultural facts or events with respect and delicacy. A therapist who is culturally sensitive is able to understand the challenges each culture experiences and the impact that may have on an individual and the decisions they make. In working with a culturally sensitive therapist, they may ask questions of clarification and not assume that the knowledge they have is the end all index of knowledge to be had.

     If cultural competency is important to you then these are concepts to address with your therapist. Explore whether they understand the differences that exist and how they handle it within their practice. What kind of books do they read? Are there any anecdotal stories they have to share? It is even fair to ask the number of minority clients they have within their current caseload. Though it is a reality that the majority of mental health clinicians experienced will be white, do not assume that there aren’t any minority identified therapists available within the practice and that the white therapist you are working with is culturally insensitive or unknowledgeable.

    It is also important to explore and identify your level of comfort in discussing this with your prospective therapist. It should be as easy to discuss as any other problem you are experiencing. Ask yourself whether you feel comfortable addressing this concept with your therapist. Are you biting your tongue? Do you feel misunderstood? This is a relationship where you should be able to voice your thoughts, ask questions and be yourself without fear of being judged. If this is an important characteristic for your therapist to have, then don’t short change your requirements and don’t let the therapist off the hook. If he or she doesn’t exhibit these characteristics, ask them the aforementioned questions as well as others if you have them. Understand that you may have to go the extra mile and educate your therapist regarding cultural norms, social pressures that exist and additional cultural components that make you unique. Therapy is about compatibility and if this is happening for you then great but if it’s not then it’s time to explore your other therapeutic options.

written by The Center for Growth - Sex Therapy in Philadelphia

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