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Culture, Diversity Competency & Sensitivity
In the field of mental health, I would dare to say that all clinicians are aware of the need to be competent in culture and diversities. The question is, are they? And, what does it mean to be culturally and diversity competent? Moreover, what does that even look like (practice)?
Given the times we live in (less naive due to access to education and technology), there is more awareness of the different cultures and diversities across communities. With that said, there are mental health professionals, such as Marriage and Family Therapists (MFTs), that are trained to be competent and sensitive of cultures and diversities, and intentionally utilize the potential implications of cultures and diversities in their therapeutic work (therapeutic alliance and case conceptualization). So, going back to the initial question, what does it mean to be culturally and diversity competent; it simply means to possess knowledge and skills that enable a person to communicate appropriately and effectively, with a positive attitude, across different cultures and diversities, including your own.
Now, how does that translate into therapy? Well, it begins with interns/clinicians being knowledgeable and mindful of their own cultural and diversity constructs informing their therapeutic work (what is focused on or not, questions formulated and how they are delivered, if any triggers, transference or countertransference, etc. ). Interns/clinicians need to be open, receptive, and respectful of other cultures and diversities aside from their own; acknowledging some of their potential limitations, need for research and supervision. Based on these fundamentals, interns/clinicians can develop a genuine therapeutic relationship/alliance, providing a safe place to ethically and respectfully identify and understand their clients' worldviews, constructed from their cultures and diversities respectively. As for the therapeutic work/approach, it depends on the interns/clinicians theory and model of choice, they may consider and utilize the implications of the client's cultures and diversities with respect to problem formulation, relational interactional cycles and patterns, identification of emotional reactivities, thought constructs, an understanding of their attempted solutions, and so forth. Essentially, interns/clinicians would conceptualize their cases using a culturally and diversity lens to assure best practices. In addition to what might have been attained from the sessions in working with the clients and their systems, the interns/clinicians would conduct a comprehensive search of any relevant research (evidence-based practice (EBP)) based on the identified client population (considering culture and diversity), the presenting problem/symptoms, and the client's goals/needs.
So, as noted, to be culturally and diversity competent, is having extensive research-based knowledge on cultures and diversities (scope may not necessarily be on all cultures and diversities, but instead some, which should be acknowledged), not to be confused with being culturally and diversity sensitive, which is the actions in accordance of the knowledge, recognizing the similarities and differences, in not judging, and adjusting accordingly (mindful of language, idioms, customs/traditions, body language, gestures, etc.). So why is any of this important? To improve client outcome of course; the interns/clinicians would possess the appropriate knowledge and be sensitive to the clients and their systems, to develop a genuine therapeutic alliance/rapport, and to be able to customize appropriate and effective approaches accordingly, minimizing barriers, reducing isms, stereotypes, biases, and so forth.
In summary, to understand people's thoughts, emotions, and behaviors, it requires an understanding of their constructs (schemas/lens/narratives/worldviews; family structure, and multigenerational transmission, cycles and patterns, and so forth), their experiences (e.g., traumas), and relationships (e.g., forms of attachments), all of which are based on the client's cultures and diversities. To do this, MFT interns/clinicians would work at different levels considering the: microsystem, mesosystem, and exosystem.
Literature on culture competency and sensitivity
Understanding Culture and Diversity Psychotherapy
Understanding what is culture
Understanding what is Diversity
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Dr. Arias Shah
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