Cultural Humility in Psychotherapy

Moving to a whole new country in my late 20s was quite a journey. I was suddenly hyperaware of different aspects of my identity, and didn’t know how to make sense of how I relate to the people and the systems around me. Therein began my search to revisit my identity and decolonize some aspects of myself and my practice in order to heal and support my clients in my journey.

The year 2020, definitely accelerated that journey as I noticed a sudden spurt in resources about social justice in the field of mental health. I had begun questioning many aspects I had previously learned after coming across individuals who had been through many systemic issues and invalidating experiences. My struggles to find a therapist who met all aspects of my identity got me thinking about the experience that a person of colour might find themselves in, in therapeutic settings. What could I be doing that could ruin someone’s experience in therapy? Does the focus on the ‘here and now’ and ‘living in the present’ work against people, when what they really need is an acknowledgment of their multi- generational trauma, impact of colonialism, systemic discrimination that requires a visit to the past? Does the focus on ‘power of rational thinking’ add insult to the injury? Isn’t it possible that a person is not perceiving things irrationally, or negatively, and that their situation is indeed working against them? If you are wondering what I am talking about, I am directly addressing a significant portion of self help books and philosophies that share the notion that ‘the power lies within you’, ‘a simple change in your approach can make a difference’, or ‘you can do it’.

The truth is, change and growth are not a simple matter of motivation or making choices. Choices are a luxury, and so is power. We all do not have equal access to either. The first step is recognizing that this is true. The second step is acknowledging privilege and/or lack of it. I definitely recognize that I have some privileges in terms of education, location, finances and at the same time seem to lack other privileges. But this is not about my personal life. This is me taking steps to ensure that I can cater, to the best of my ability, to my clients who may not have the same privilege as I do.

I also recognize that me being a person of colour does not mean that I cannot be ignorant and unknowingly make inappropriate judgments. I, like all of us, definitely have blind spots, and am fully aware that my own perceptions can be biased. I don’t believe I will be perfect, but I am going to spend significant time educating myself. I will share what I learn, in the hopes that this will contribute to everyone’s well being. At the same time, I invite you to share resources, ideas, and suggestions that you have that will help me become more culturally competent. This is not meant to replace therapy or supervision, but simply an attempt to share what I learn, and learn from you as well.

Below, we will take a look at a few ways to know we are culturally encapsulated, and signs that we need to change as well as a very useful model that can help us keep track of all factors that affect an individual’s well being. The source of my information has been listed below for your reference.

In the first article I read, I come across Gilbert Wrenn who explains that counselors can run the risk of being culturally encapsulated. Here are some signs, us counselors can know that we are culturally encapsulated

1. we hold the same standards of behaviour for everyone
2. individualism is deemed more appropriate than collectivism
3. narrow professional boundaries are sought & interdisciplinary interaction is discouraged
4. contextual influences are not taken into account
5. dependency is considered undesirable or neurotic
6. a person’s support system is not considered relevant to mental health
7. linear, cause-effect thinking is considered sufficient
8. expect individual to adapt to the system
9. historical roots are disregarded or minimized
10. counselors assuming they are free of racism or cultural bias

The second article I read, is simply fantastic. It spoke about RESPECTFUL Model developed by Michael D’ Andrea & Judy Daniels. The model lists 10 things that influence an individual’s psychological well being. I believe having an acronym at hand would definitely be useful for me to check myself and see if there is something I fail to acknowledge/address in therapy.


1. Religious-Spiritual Identity: It could be religion a person chose, or a religion someone was born into. A person can even choose to be spiritual, agnostic, or atheist.
2. Economic: Different economic situations have different impacts. Poverty is definitely associated with many ACES (Adverse Childhood Experiences).
3. Sexual Identity: Historically, people have been oppressed because of their sexual identity, gender identity, partner preference, and it is important to learn and educate ourselves on their experiences and the risk to their mental health. Centre for Suicide Prevention has a very useful fact sheet about sexual minorities and suicide which can be found here
4. Psychological Maturity: focusing on individual’s ability to adapt to the environment based on their psychological strengths
5. Ethnic Cultural Racial Identity: some ‘within’ group experiences would be important to note. I would also focus on asking clients’ their perception of their experience, to ensure my stereotypes is not influencing therapy
6. Chronological Developmental Challenges: any developmental delays or challenges may affect individual experiences. This makes me think especially of individuals with medical conditions, invisible disabilities that are likely to experience significant challenges early on, especially in school settings
7. Trauma and other threats: To me, learning more about ACES as well educating myself about Trauma Informed Approach led to a huge shift in the way I perceive people in general and I would recommend Trauma Informed Approach to everyone. More information about ACES can be found here. One of the best resources I have used for Trauma Informed Approach is the toolkit by Manitoba Trauma Information and Education Centre which can be found here.
8. Family History and Dynamics: there are so many things to consider here. There are many different types of families, blended families, diverse families, nuclear or joint families, etc. How they view themselves and how they are viewed in by society can play a huge role in the mental health. Different generational experiences, especially in migrant families are also noteworthy.
9. Unique Physical Characteristics: people who are physically different, in terms of height, weight, physical limitations, colour of their skin, age, may have experiences different from those of the norms. It also becomes important to check our own negative stereotypes about appearances.
10. Location of Residence and Language Differences: Each location brings with it a lot of influence in terms of climate, terrain, diet, job market, access to resources, media influence or lack of it, finances, cultural influences, colonial and/or migration history, stereotypes, cultural strengths, among others. It would be important to understand the client in this larger context and their experience of it to help check any biases or stereotypes we may have. I remember working with a child who lived in a slum. While I complained to him about child labour and thought it wasn’t fair, he on the other hand, saw it as an opportunity to pull his family out of poverty rather than a social evil. Which was my first lesson in how my idea of the what the client experiences, need not be accurate all the time.

Therapists, this is not written with judgement, but more an attempt to share and learn from one another. 

Clients, your therapist wants to know how they are doing. Communicate with them, call them out, and collaborate with them as no therapy is successful without collaboration. 

I would love to know what you think about this blog. If there are more resources, ideas, or topics that you would like me to explore, comment below or write to me at krishnavoratherapy@gmail.com.

If you would like to book a free 15 minute consult with me click here.

References/Credits
-Photo Credits: Nathan Dumlao https://unsplash.com/@nate_dumlao & nathandumlaophotos.com
-Emeritus, P. B. (2002, August 1). The Making of a Culturally Competent Counsellor, International Association for Cross Cultural Psychology. Retrieved June 16, 2020, from https://scholarworks.gvsu.edu/cgi/viewcontent.cgi?article=1093&context=orpc
-10 Multicultural Factors to Consider in Counseling. (2017, April 5). Retrieved June 16, 2020, from https://onlinecounselingprograms.com/blog/multicultural-counseling-model/

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