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Culturally Sensitive Therapy

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Culturally sensitive therapy is an approach to psychotherapy that emphasizes the therapist's understanding of a client’s background and belief system as it relates to their race, ethnicity, sexual orientation, gender, or other important elements that make up someone’s culture and/or identity. Therapists can incorporate cultural sensitivity into their work to accommodate and respect differences in the opinions, values, and attitudes of various cultures and different types of people and to provide the most effective treatment for a particular client.

Cultural sensitivity allows a therapist to gain and maintain cultural competence, which is the ability to first recognize and understand one’s own culture and how it influences one's relationship with a client, then understand and respond to a culture that is different from one’s own. The need for this understanding may be based on characteristics such as age, beliefs, ethnicity, race, gender, religion, sexual orientation, or socioeconomic status.

Finding a therapist who is culturally sensitive can help clients—especially those who don’t identify with the dominant culture group—feel understood by their therapist, which often contributes to a stronger therapeutic alliance. By contrast, feeling as if a therapist doesn’t understand or respect one’s culture can lead some clients to give up on therapy or avoid seeking it altogether. In recent years, widespread societal discussions and shifting ideas about race, gender, sexual orientation, and other related topics have increased the demand for culturally sensitive therapy, and many therapists now actively seek to increase their cultural competence through education, training, and self-reflection.

When It's Used

Cultural sensitivity practices are not tied to one therapeutic modality. Rather, they can be applied to any type of therapy or client concern, ideally helping the client feel more comfortable, strengthening the therapeutic alliance, and making the treatment more effective. Therapists who identify as culturally sensitive may practice individual therapy, couples therapy, or group therapy.

While some therapist training programs now mandate classes in cultural sensitivity, others do not; therefore, it’s often necessary for therapists to seek out additional training or education in order to become more culturally competent. Cultural competence can also be strengthened through self-reflection and individual therapy.

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What to Expect

A culturally sensitive therapist follows guidelines for working with diverse groups of people and understands that racial, cultural, religious, gender, and sexual identities interact with one’s beliefs and behavior. The expectation and ultimate goals for both the therapist and the client are notable progress and improvement, sometimes despite cross-cultural boundaries and differences.

Therapists who successfully integrate cultural sensitivity practices into their treatment recognize and respect differences and take steps to communicate and interact empathetically with clients from diverse backgrounds. At the same time, they recognize that every individual is unique and that two clients who hail from the same culture may still have very different beliefs, values, and preferences. A culturally competent therapist will therefore keep an open mind and ask questions to determine which approach is best for a particular client.

Research has helped document the positive effects of cultural sensitivity practices and has also outlined specific examples of how therapists can be more culturally competent in their interactions with clients of different backgrounds. For instance, one study noted that therapy with Latino clients tended to be less effective when the therapist was seen as distant. Understanding and applying the cultural expectation of disclosing some personal information, for example, may help clients who identify as Latino feel a stronger bond with their therapist.

Other studies show that certain behaviors, such as familiar use of language and a general display of personable traits, can play a particularly important role in some cultures; avoiding these approaches can alienate clients. Alternatively, some studies have found that clients who hail from more collectivist Eastern cultures may feel more comfortable when their therapist takes on an “expert” role and may dislike the more collaborative approach that is common in Western, individualist cultures. Being aware of these potential preferences, and tailoring their approach accordingly, can help therapists formulate treatment plans that are suited to each client.

Importantly, therapists should demonstrate knowledge of how events that take place outside the therapy room could be affecting their client’s well-being or state of mind. Clients of color may feel distressed by racial tension or race-related protests, for example; acknowledging this during therapy, and discussing it directly if the client wishes, can help clients feel like they don't have to censor themselves for their therapist's comfort.

Therapists who practice cultural sensitivity may deviate from standard therapeutic methods; however, they must also adhere to their profession’s ethical guidelines, for example, when it comes to the disclosure of personal information.

How It Works

Advocates for cultural sensitivity argue that it is more effective to vary the therapeutic approach from person to person, depending on a client’s culture, than to simply use the same standard treatment approach for everyone. Cultural competence is also thought to vastly improve the therapeutic alliance—even if therapist and client do not share the same culture, a client who feels like her culture is recognized and acknowledged will likely feel closer to her therapist than one who feels like her identity is ignored or minimized. While some therapists argue that highlighting differences between individuals may offend some clients, and therefore damage the therapeutic relationship, it is generally believed that openly showing respect for someone’s culture and beliefs can result in more effective treatment and a more positive outcome for both client and therapist.

What to Look For in a Culturally Sensitive Practitioner

An individual seeking a culturally competent clinician should look for a licensed therapist or counselor who communicates an awareness of the client’s culture, beliefs, and practices. It’s OK for potential clients to ask questions about the therapist’s familiarity with their specific culture, as well as determine whether the therapist’s goals and strategies align with the client’s own. As with any therapist, clients should seek someone with whom they feel comfortable discussing personal issues.

Barnett JE and Bivings Nd. Culturally sensitive treatment and ethical practice. American Psychological Association Divisions. Division 31: State, Provincial and Territorial Psychological Association Affairs.      
Sue S, Zane N, Hall GC and Berger LK. The case for cultural competency in psychotherapeutic Interventions. Annual Review of Psychology. 2009;60:525-548.
American Psychological Association. Guidelines for providers of services to ethnic, linguistic, and culturally diverse populations.
American Speech-Language-Hearing Association
Tsui, P., & Schultz, G. L. (1985). Failure of rapport: Why psychotherapeutic engagement fails in the treatment of Asian clients. American Journal of Orthopsychiatry, 55(4), 561–569.
Last updated: 09/19/2022