guest blog by Courtney Rolla, MA, LCPC, SEP
Safety in the Therapeutic Relationship
Effective therapy relies on finding a safe space in the therapeutic relationship. That means that the client feels safe to be themselves and perceives that they are accepted – free of judgment, criticism, and other emotional harm. It is the therapist’s job to create this safe space. Unfortunately, one key aspect of creating safety has too often been overlooked: the therapist’s own cultural humility and cultural competency. Below we will learn what cultural humility and competency are and why it is so important for therapists and clients to understand these concepts.
What are Cultural Competency and Cultural Humility
Cultural competency means taking into consideration and having an awareness and understanding of a person’s varied aspects of lived experience. This includes a person’s culture, beliefs, values, socioeconomic status, race, ethnicity, sexuality, gender, ability, and religion to name a few facets. To be culturally competent is to see all aspects of a person. Thankfully, cultural competence in mental health has become an increasingly strong value in the profession.
An equally important component of cultural competency is understanding intersectionality. Intersectionality is having a lens or mental framework of how aspects of an individual’s life and components of their identity come together in unique combinations of discrimination and privilege. Intersectionality encompasses our complex makeup as individuals and how we interact with and experience the world. A client brings all of this into the room, so it is essential for a therapist to make a safe space for all of a person. Moreover, it is advantageous for every therapist to understand their own privilege.
In the therapeutic relationship, there is an inherent power differential. The therapist is a helping professional, there to provide support for the client. So, in creating a safe space, the therapist ideally will work to minimize this power differential. That includes cultural competence skills such as understanding intersectionality, and how the therapist’s privilege as “the expert” influences the therapeutic dynamic. Other ways in which a therapist can have privilege are by having majority status with respect to race, gender, and sexuality. Understanding the past and present social implications of this privilege is essential in preventing harm and minimizing implicit biases.
Another component of creating safety in therapeutic relationships is cultural humility. Cultural humility comes from a process of self-reflection, exploration, and critique with an openness and willingness to learn from others. This involves acknowledging and honoring the values, beliefs, and customs of other people. The concept is like the saying “Treat others as experts in themselves.” Cultural humility in a therapist supports collaboration, learning, and dialogue in the therapeutic relationship.
Related Reading: How to Find a Therapist- 5 Steps
Why Cultural Competence and Humility Are Important
As previously mentioned, safety is paramount in therapy. Too often in the past (and unfortunately sometimes still in the present), cultural differences, especially those of minority groups, were pathologized. For example, homosexuality was once listed in the Diagnostic and Statistical Manual I as a diagnosable mental disorder. It was finally removed in 1973. This type of harmful pathologizing is often derivative of privileged groups, such as white, religious males, who have largely influenced the foundation of the psychology field.
This is just a brief example of how a lack of cultural competency and humility can do great harm. This type of harm is dehumanizing and perpetuates shame, othering, and stigma. This type of lens leads to micro and macroaggressions. Groups that are often viewed as minorities in Western culture are, in fact, the world majority. Therefore, rather than supporting a client only through the lens of their own lived experience, a therapist needs to support clients by intentionally incorporating clients’ cultural lived experiences.
Related Reading: How to Open Up to a Therapist About Trauma
Cultural Competency and Humility in a Therapy Session
There are many ways culturally competent care can be visible in therapy. For example, it can start with having an accessible office location that has handicapped parking, ramps, and an elevator. This takes into consideration people with mobility needs and allows them access to therapy.
Intake paperwork, which is usually required of every client, should have inclusive questions such as asking for a client’s preferred pronouns and providing space for a client to share important religious and cultural beliefs. Furthermore, a therapist should be open and curious. For example, close relationship dynamics can often be labeled and generalized as enmeshed or codependent, which often has a negative connotation. However, a curious and non-judgmental therapist should explore these dynamics from the client’s cultural lens. Is the dynamic resourceful for the client? What would it mean for the client if they attempted to change this dynamic?
There are endless ways that cultural competency and humility can be present in a therapy session. For example, as a Somatic Experiencing therapist, I like to strongly encourage clients to ultimately trust their gut – the body has wisdom. It is normal to feel nervous and hesitant as you approach therapy, especially early on. However, if tension, uncertainty, or even fear persists, it could be worth exploring. Do you feel seen and heard by your therapist? Do you feel like your therapist respects your culture and unique identity? It may not always be an issue of cultural incompetence, but it definitely is something to reflect on.
How to find a Culturally Competent Therapist
All of this can be overwhelming for a client to remember. Ultimately, it is the therapist’s job to create a safe space and to be culturally competent and humble. However, below is a list of ways to find a culturally competent therapist.
- Therapist database filters: Websites such as Psychologytoday or Somatic Experiencing International give you access to thousands of therapists. Adjusting filters on the websites to narrow down therapists based on their race, gender, or incorporation a particular religious lens can connect you with a therapist you may identify with.
- Look for key phrases that indicate a therapist is an ally or a part of a community: Key phrases you may want to look for include, LGTBQIA+ Affirming, Body Positivity, or BIPOC therapist.
- Word of mouth: Ask people you trust from your identity communities if they are familiar with culturally competent therapists.
- Ask your therapist questions: Are you familiar with my culture, religion, community, etc..? Have you had experience working with people from my community? Have you had cultural competency training?
- Explore organizations: Some organizations specialize in supporting various communities. A few are:
Beam:Black Emotional and Mental Health Collective
In the end, it is paramount for a client to feel safe in therapy. Many components go into creating a safe therapeutic relationship. An essential component of creating safety in therapy and providing effective therapy is a culturally competent and culturally humble therapist. It is important that the client feels understood and accepted for all parts of themselves. Don’t be afraid to ask questions and trust your gut!
Courtney is a trauma therapist at Life Care Wellness, a group psychotherapy practice in Glen Ellyn, Sycamore, and Chicago (Jefferson Park neighborhood), Illinois. She is a trauma specialist utilizing a Somatic Experiencing framework to utilize the body’s wisdom in healing. She also uses attachment theory and a variety of traditional psychotherapy approaches in her work. Courtney currently offers telehealth sessions only and is accepting new clients.
