Culturally Sensitive Therapy

Cultural sensitivity is not a therapeutic modality (e.g., cognitive behavioral therapy), but a series of therapeutic practices that work across any number of modalities to strengthen therapeutic alliance. Cultural competence on the part of a mental health provider or therapist can help increase the likelihood of positive outcomes. Conversely, clients who do not perceive that a therapist understands their experience are more likely to abandon their therapeutic treatment early. 

In addition, therapy treatment goals and strategies can look different across different cultures. A therapist who is trained in cultural sensitivity can recognize these differences, and interview the client to determine a treatment approach that will work best for them. For example, research has found that individuals from Eastern cultures expect their therapist to be an “expert,” and may not respond as well to a collaborative approach. On the other hand, it has been observed that Latino clients do not respond as well to therapists who appear personally distant. 

When a client knows that a therapist is educated or knowledgeable on events that are experienced in their culture, they may get more out of therapy. Clients who are LGBTQ will often feel more comfortable sharing their experience if the therapist is also LGBTQ, an openly acknowledged ally, or otherwise culturally sensitive. By increasing participation during sessions, no matter which therapeutic modality is used, culturally sensitive therapy can be far more effective. 

Not all therapists are trained and competent in cultural sensitivity. Many people assume that this is part of a therapist’s training, but this is not always the case. In fact, in a 2022 review of cultural competence training for mental health professionals and therapists, less than 75% of curricula focused on race and ethnicity. 

Determining what questions to ask

Because there is no test or formal certification for cultural competence, it often falls on the clients themselves to find a therapist who is educated on and respectful of these cultural values and is “always learning,” discovering ways to understand society’s challenges and best support their clients. Finding a culturally sensitive therapist who fits your needs may require some research. Be prepared to ask questions about their qualifications and ability to provide culturally sensitive therapy. Some questions that may be helpful include:

• Can you tell me more about your education and training for working with diverse populations?
• How familiar are you with my specific background or culture?
• Are you bi-lingual?
• Are you willing to learn more about my beliefs, culture, and/or values? 

Individual therapists must seek their own continuing education, exposure, and training around many important topics, areas of focus, therapeutic modalities, etc. This intentional approach toward increasing awareness is not limited to cultural sensitivity. 

Prospective clients can ask as many questions as they want of any therapist they’re considering to determine their respective comfort with that therapist. This often applies to age, gender, and therapeutic approach, as well as issues like cultural sensitivity.

Culturally sensitive therapy, or culturally responsive therapy, can be beneficial for anyone—especially for those who do not identify with the dominant culture group. Historically marginalized groups have experienced challenges with therapy over the years, including poverty, lack of cultural awareness, disparity in availability, and stigmatization¹ of therapy within their culture. 

Connecting with a culturally competent therapist who listens, acknowledges, and respects an individual’s experience and preferences can help instill trust in participants. By building a foundation of respect, the individual is more likely to continue therapy, make goals that are relevant to their own cultural experiences, and have a better overall experience.

Because culturally sensitive therapy principles can apply to a number of different therapeutic modalities, the overall goals are the same as they are with psychotherapy² in general. That is, to create greater mental well-being through response, remission, and recovery. 

A key factor in effective mental health treatment is continuing therapy until recovery is reached. The challenge is that according to studies, around 50% of clients will discontinue therapy before recovery is reached, with many dropping out after the first few therapy sessions. 

Culturally sensitive therapy involves recognizing a person's culture as an essential part of their identity and therefore adds a level of assurance for the client that may allow them to have less difficulty participating for the necessary time for recovery. Properly applied, this type of practice can help destigmatize therapy for clients, add dimensions to treatment that are relevant to their experience, and build trust between the client and therapist.

A review of cross-cultural psychotherapy research published in 2021 found that critical reflection in the therapist is vital for successful cross-cultural therapy, and yet can be challenging, especially when it comes to addressing biases. One study found that in the majority of cases it was the client themselves who initiated conversations about social class during cross-cultural therapy, and not the therapist. Overall, it was determined that there is a need for further research into cultural sensitivity in mental health care and therapy, as subtle nuances are required for successful cross-cultural therapy, and this can be difficult to train. 

A 2013 case study observed that the client, who was treated with cognitive behavioral therapy that had a strong emphasis on cultural sensitivity, showed significant progress due to the alliance built between themselves and the therapist. The client self-reported that she felt respected, heard, and empowered with contributions to her own progress, which offered her the confidence to continue applying learned skills even after therapy sessions had ended. She also reported feeling encouraged to continue with the cognitive behavioral therapy sessions because of the therapist’s willingness to acknowledge their own cultural background.

An article published in 2022 found that although researchers have taken care to include minority groups in treatment research, the majority of clinical trials still lack significant samples of ethnic minorities to analyze the effects of ethnic and racial status on treatment outcomes. The authors call for a closer, and broader, examination of these topics through partnerships with communities, and key stakeholders in these communities to promote evidence-based practices that apply to all.

Finding a therapist who is culturally competent may take some extra work, depending on where you live. In some geographical areas, there is a lack of access to specialization in therapy. To find a therapist to provide treatment that can overcome cultural and socioeconomic barriers and who can provide culturally sensitive therapy, there are a few steps you can take. 

First, research your options. Ask for therapist recommendations from trusted loved ones and friends. Your healthcare provider may also be able to give you referrals for therapy. Next, ask the therapist questions about their training and experience with your background. If you are not comfortable with the therapist after meeting with them, do not be afraid to search for someone else. 

Online therapy

A good option for finding a culturally sensitive therapist is online therapy. With an online therapy platform like BetterHelp, you can be matched online with one out of 30,000+ therapists who meets your needs by filling out a simple online questionnaire. You may also change therapists without financial penalty. Therapy sessions take place via video conferencing, in-app messaging, or over the phone.