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Cultural Considerations in Therapy

For many of us, our culture is one of the most important parts of who we are. It plays a large role in how we think, feel, and see the world.  

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Cultural Considerations in Therapy

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For many of us, our culture is one of the most important parts of who we are. It plays a large role in how we think, feel, and see the world.

  • What is the definition of cultural considerations in therapy?
  • What are the cultural differences in therapy?
  • What are examples of cultural considerations?
  • What are cultural considerations in therapy in psychology?
  • What is the importance of multicultural considerations in therapy?

Definition of Cultural Considerations in Therapy

Emphasizing cultural considerations in therapy requires the therapist to clearly understand the client's ethnicity, background, and belief system.

This allows the therapist to be sensitive to how a person's culture impacts their needs in therapy.

Culturally sensitive therapy prioritizes a person's cultural and ethnic characteristics in therapy.

Many cultural groups may be negatively stereotyped or discriminated against. Understanding the ways in which this can affect the client will allow the therapist to gain better insight into the support they need.

Cultural considerations include race, religion, culture, ethnicity, sexual orientation, and/or disability. America has an incredibly dark past in discrimination against people of cultural minorities. While there have been improvements, people can still encounter persistent stress due to their cultural differences.

Cultural Differences in Therapy

Cultural differences in therapy can significantly impact whether or not a person will seek out therapy. Also, it is essential to keep in mind the differences between individualistic and collectivistic cultures.

In individualistic cultures, personal desires and identity are prioritized.

It is often acceptable to talk about yourself and be open, so it can be easier for clients from individualistic cultures to feel comfortable in therapy.

On the other hand, collectivist cultures expect people to prioritize social and familial responsibilities above personal desires.

Therefore, it may be more difficult for individuals from collectivist cultures to talk about themselves and feel comfortable in a therapy setting. Their culture might encourage them to keep their feelings personal and to themselves.

Cultures even differ in their beliefs in the value or benefit of therapy itself. Many cultures, especially African-Americans, typically have a lower level of trust in health care, often due to the history of unethical procedures done on black people in America. You may be part of a "culture of honor" that praises being strong and tough and hiding your emotions. As a result, you might refuse therapy because you don't want to be seen as "weak." Maybe your culture believes issues such as depression should be handled by the family or religion only. Some cultures may be reluctant to seek therapy and are quick to leave.

Cultural Considerations in Therapy, man hiding in bathroom crying, StudySmarterFg. 1 Crying in secret, Freepik.com

Finally, some cultures simply do not have access to therapy due to socioeconomic status. Therapy can be costly, especially if you do not have healthcare. Someone may be struggling with suicidal ideation but cannot get the help they need because they cannot afford it or have any way of getting there in the first place.

Examples of Cultural Considerations

Cultural considerations can be broad and include several different groups, such as immigration status and religion.

Immigration Status

Immigrants often have to survive extremely difficult conditions and hardships to make their way to America. This can have a significant impact on a person's mental health. Individuals and families may relocate to escape terrorism and other dangers in their homes and build a better life for themselves. Immigration status can also play a role in a person's mental health.

Undocumented immigrants may feel as though they always have to look over their shoulders or hide in fear of being deported home. It may cause higher instances of worry, health problems, discrimination, loneliness, and isolation. It is important for therapists who are focused on cultural considerations in therapy to keep these factors in mind. Immigration detention facilities, for example, can have a profound effect on immigrants and may cause depression, intense stress, and even post-traumatic stress manifested with sadness, flashbacks, and feelings of hopelessness.

Cultural Considerations in Therapy, immigrant family crossing city street, StudySmarterFg. 2 Immigrant family, Pixabay.com

Even immigrants with temporary or permanent visas can be at risk of a mental health crisis. Cultural considerations in therapy must recognize the incredible challenge immigrants face while living in a country not their own, speaking a language not their own, and being far away from their family and home. Immigrants may experience extreme feelings of loneliness and longing for home, which may cause these symptoms. It is essential for a therapist who emphasizes cultural considerations to detect when a person's issues are due to depression or simply adjustment. In either case, immigrants can benefit from psychotherapeutic support.

Someone from a small town, who knew everyone they encountered in the day, may feel overwhelmed feeling anonymity in large crowds.

Religion

According to the Princeton Religious Research Center, 66% of Americans consider religion an important part of their lives. As such a large part of many of our lives, religion and spirituality are important parts of cultural considerations in therapy. However, many mental health professionals receive minimal training in supporting clients with spiritual and religious issues in psychotherapy.

Highly religious people may prefer and benefit from therapists who share their beliefs. Even a therapist who is sensitive and willing to interact in a religious or spiritual way can increase trust and rapport with religious clients.

A person's faith or spiritual community can be a powerful source of support in a client's life. Mental health professionals who are sensitive to their beliefs may be able to use this as a way to treat a religious or spiritual client.

However, therapists should still tread carefully, ensuring their views do not interfere with treatment.

Cultural Considerations in Therapy Psychology

Many psychologists today believe that cultural considerations in therapy should be ethically required to "do no harm." To ignore cultural considerations in therapy would mean failing to provide the greatest level of care that every human being deserves. To do this, the Association for Multicultural Counseling ad Development (AMCD) says a therapist must be mindful of three considerations when providing multicultural counseling.

  1. The therapist or counselor must be aware of their cultural values and biases. Making stereotypes or judgments is natural for all of us. It's how our brains organize and understand the world. However, therapists should be trained to be aware of their values and potential biases to ensure it does not interfere with providing the best quality of care.

  2. The therapist or counselor must be aware of the client's worldview. This is the foundation of culturally sensitive therapy in order to tailor therapy specifically to them. A therapist who understands or aligns with a client's spiritual beliefs may be able to use it as an effective tool for healing.

  3. The therapist or counselor should be careful to consider culturally appropriate intervention strategies. Cultural are often linked to spiritual beliefs. If your culture or religion does not believe in drawing blood or any medical intervention whatsoever, it would be inappropriate for your therapist to recommend donating blood as a way to give back.

As we mentioned earlier, some cultures, especially collective cultures, frown upon a person talking about themselves. As a workaround, a therapist may ask the client to tell a story as a way to reveal their underlying issues and feelings. Family can be central to many cultures. Therefore, engaging a person's family in therapy can reinforce a sense of safety during treatment.

Cultural Considerations in Therapy, boy and father praying in mosque, StudySmarterFg. 3 Religious cultural considerations in therapy, Freepik.com

Importance of Multicultural Considerations in Therapy

The importance of multicultural considerations in therapy is especially apparent. Showing respect for someone's culture and beliefs can go a long way in making them feel seen and heard. Multicultural considerations in therapy can help a therapist avoid any offensive or inappropriate suggestions, behaviors, or reactions, enabling the client to feel safe opening up to their therapist.

Using a person's correct pronouns is an effective way for a culturally sensitive therapist to show the client respect.

A person's race or heritage can play a role in their health and some ethnic groups are at more risk for health concerns than others. Some studies have shown that when a client is matched with a therapist who shares their cultural values and beliefs, they are likely to perceive more empathy from the therapist as well as a stronger alliance (Kim et al., 2005).

Cultural Considerations in Therapy - Key takeaways

  • Culturally sensitive therapy prioritizes a person's cultural and ethnic characteristics in therapy.
    • Culturally sensitive therapists should be aware of their own cultural values and biases, aware of the client's worldview, and consider culturally appropriate intervention strategies.
  • In individualistic cultures, personal desires and identity are prioritized. Collectivist cultures, on the other hand, expect people to prioritize social and familial responsibilities above personal desires.
  • Cultures even differ in their beliefs in the value or benefit of therapy itself. You may be part of a "culture of honor" that praises being strong and tough and hiding your emotions.
  • Immigrants often have to survive extremely difficult conditions and hardships to make their way to America. This can have a significant impact on a person's mental health.
  • Many psychologists today lean towards the belief that cultural considerations in therapy should be ethically required to "do no harm." To ignore cultural considerations in therapy would mean failing to provide the greatest level of care that every human being deserves.

Frequently Asked Questions about Cultural Considerations in Therapy

Showing respect for someone's culture and beliefs can go a long way in building trust and rapport.  Multicultural considerations in therapy can help a therapist avoid offensive or inappropriate suggestions, behaviors, or reactions, enabling the client to feel safe opening up to their therapist.

Cultural considerations include race, religion, culture, ethnicity, sexual orientation, and/or disability.

Some cultures, especially collective cultures, frown upon a person talking about themselves.  As a workaround, a therapist may ask the client to tell a story as a way to reveal their underlying issues and feelings.

In individualistic cultures, personal desires and identity are prioritized. On the other hand, collectivist cultures expect people to prioritize social and familial responsibilities above personal desires.


Many cultures, especially African-Americans, typically have a lower level of trust in health care, often due to the history of unethical procedures done on black people in America.

Some studies have shown that when a client is matched with a therapist who shares their cultural values and beliefs, they are likely to perceive more empathy from the therapist as well as a stronger alliance (Kim et al., 2005).

Test your knowledge with multiple choice flashcards

It may be more difficult for individuals from ____________ cultures to talk about themselves and feel comfortable in a therapy setting

You may be part of a ___________ that praises being strong and tough and hiding your emotions.

Some cultures simply do not have access to therapy due to _____________. 

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