Cultural Humility in Therapy: Why Recognizing Culture Matters
When I was in graduate school, workplaces, schools, and organizations were paying more attention to diversity and culture which was encouraging. In our current sociopolitical climate, the emphasis on diversity and cultural differences is facing real threats of erasure. While this is discouraging, infuriating, and frustrating, attention to culture without follow-through can have real consequences in the therapeutic space.
As mental health professionals, we enter this work with the best of intentions. But intention alone isn’t enough. We must actively recognize cultural factors, assess them from the very first meeting, and remain mindful of how they influence our communication and care throughout therapy.
The ADDRESSING Model: A Starting Point
You may be familiar with Dr. Pamela Hays’s ADDRESSING model, which helps therapists assess clients holistically, including aspects like age, disability, sexual orientation, socioeconomic status, indigenous heritage, and gender.
While this model is a strong foundation, it doesn’t fully account for the ways systemic oppression and societal inequities affect clients’ experiences. Every dimension of the model intersects with unique challenges.
For example:
BIPOC individuals may encounter both overt and subtle racism, which can impact self-esteem, anxiety, and emotional regulation.
Research links racial discrimination with physical health outcomes, including cardiovascular stress.
Cisgender women, transwomen, and gender nonconforming clients may experience sexism differently depending on intersecting identities.
Recognizing these realities isn’t just about theory, it’s about creating therapy that actually works for the client in front of you.
Practicing Cultural Humility With Clients
You might be wondering, “How do I even begin to assess for these issues without overstepping?”
Here are three practical approaches I use and recommend:
1. Do Your Own Research
It’s important to understand your clients’ cultural backgrounds without relying solely on them to educate you. This might mean:
Learning about specific cultural practices, traditions, and social norms (outside of session).
Admitting in session when you don’t know something, and asking if the client is comfortable explaining.
Consulting colleagues or trusted resources to deepen your understanding.
The more prepared we are, the less the burden falls on the client, and the more confident we can be in providing culturally responsive care.
2. Immerse Yourself in Cultures Outside Your Own
Cultural understanding doesn’t require living someone else’s life, but it does benefit from genuine engagement:
Attend local cultural festivals or community events.
Listen actively when friends or colleagues share experiences from their culture.
Watch documentaries or read first-person accounts that go beyond media stereotypes.
Remember: sharing a cultural identity doesn’t mean shared experience. Assumptions, even well-meaning ones, can undermine therapeutic rapport.
3. Be Intentional With Language
Words have power; they can heal, harm, or inadvertently create distance. Small changes in phrasing can make therapy feel inclusive and safe:
Instead of asking “Were you raised by your parents?” ask “Who lived in your home growing up?”
Instead of asking “Are you attracted to men or women?” ask “Who are you attracted to in romantic relationships?”
Rather than asking clients directly if they’ve experienced “trauma,” ask about difficult or upsetting experiences that were unusually challenging for them to move beyond.
Language matters because it communicates respect, recognition, and understanding of each client’s lived reality.
The Power of Cultural Humility
Being culturally humble isn’t a one-time effort: it’s an ongoing, intentional practice. It requires acknowledging privilege, confronting discomfort, and reflecting on how we may unknowingly reinforce systemic inequities.
The effort is worth it. Consistently prioritizing cultural awareness allows us to build trust, deepen understanding, and provide therapy that truly meets the needs of diverse clients.
Ultimately, recognizing and honoring cultural differences isn’t just “nice to have.” It’s essential. It ensures that every client can feel seen, respected, and supported on their healing journey.