“We are what we are because we have been what we have been, and what is needed for solving the problems of human life and motives is not moral estimates but more knowledge.”
-Sigmund Freud
Inherent oddities aside, Sigmund Freud is often regarded as the father of psychotherapy. However, that’s where his contribution to this article ends. Freud’s position that therapists must understand their patients through knowledge rather than moral relativism is a key ideal of modern therapy. However, it is sad to see that the American mental health industry is still suffering from a glut of mental health professionals who not only refuse to recognize their patient’s cultural backgrounds and experiences but actively discriminate against people that don’t match their cultural ethics.
Therapists are supposed to be the haven of humanity. People in counseling careers must constantly remember that they are dealing with people in varying states of vulnerability and pain. Yet minorities in the USA are constantly met with resistance when trying to receive mental health care, and should they get it, they face the very real prospect of being met with substandard care - or even just racial prejudice. Addressing this issue takes a working understanding of cultural sensitivity, which at its heart is exactly what Freud was talking about. Therapists must put aside moral estimates, and look at Culturally And Linguistically Diverse (CALD) clients to seek knowledge.
1. Cultural Sensitivity - Respect in Division, Empathy in Unity
We all have a nationality, a heritage. Depending on how you’ve been raised/the life you’ve lived, this heritage may or may not be more or less important to you than some others. Maybe you’ve lived all your life as a proud Asian, and you’re faced with a client to whom your cultural customs and values are entirely different. How do you proceed?
This is the role of Cultural Sensitivity, or as Ashlee Wisdom, MPH, CEO and founder of Health in Her Hue describes it:
“Care that is given to a patient that takes into account their lived experiences and their social and cultural contexts.”
For example, the act of circumcision is hotly debated in human rights circles. For one instance, it is a case of harming a person, and clearly “wrong.” However, when you take into account that many cultures practice circumcision as a right of passage, with modern technology/techniques and consent from the patient, is it not then a breach of human rights to deny a person the procedure?
A culturally sensitive therapist meets clients, and when addressing their desires, does their utmost to remember the patient’s cultural background, and respects/adheres to cultural norms as much as possible while delivering treatment. They respect the division between them but practice empathy as joint members of humanity. Remember, it is an ethical violation to administer service to a person with whom you know that your biases are incompatible.
2. How to Be Culturally Sensitive
Despite counseling being a profession rooted in the very human desire to help other humans, the sad fact is that therapists in the modern USA are still giving way to racially fuelled biases. Minorities and low-income families face a detrimental lack of support when attempting to address their mental issues, owing to either racism or a lack of access to insurance or transportation.
Aside from the inherent negativity of racial bias toward those who require mental health support, the stagnation of the mental health industry in an increasingly colorblind USA, is becoming detrimental to a system that was meant to support everyone.
Part of the problem is the failure of the mental health system to realize its racist origins, where psychiatrists in the 1800s deemed black people incapable of looking after themselves, and reported that slavery was beneficial to their mental state. This history, and lack of specialized support, has led to a perception among minorities that they cannot seek mental health support for fear of further discrimination and victimization.
Although the previous examples related specifically to the African-American community, the same biases can occur with all races. Therapists need to remember how important cultural sensitivity is in their work, and to remember that culture doesn’t just include biases of race or nationality, but that culture can take into account political affiliation, gender identity and sexuality, communities, cultural movements/ideologies, and more. Some all-around things to remember when administering treatment or support include:
3. When dealing with a client, you cannot allow personal biases to intrude
Your patient is not sitting in your office to deal with you in a debate of ethics. Your role as a mental health professional is one of neutrality in all things. Any political/social affiliations you have must be left outside the office when you enter it. You can pick them back up when you leave your office. You are here to look at a person as a human being, to take into account their lives, and their ideals, and meet them on their mental home ground. You’re not there to judge, you’re there to engage as a person.
4. Investigate the client’s culture
Part of the job of a therapist is to ask questions and accept the answers without judgment. Doing so about a client’s culture and any cultural perspectives is not disrespectful, it shows the patient that you are attentive and going the extra distance in providing specialized care. As a therapist, you should have a healthy interest in the perspectives of others. See this as an opportunity to learn more, and your therapy will be all the better for it
5. Understand your client’s cultural relationship
Just because we all have a heritage doesn’t mean we necessarily have a good relationship with it. Your client may love their cultural background, or they may have clashed with their upbringing and that conflict is key to understanding their trauma. People are not carbon copies of one another, treating them so is detrimental to the industry
6. Pick up what they put down
If your client mentions something that sounds poignant, ask about it. Ask if it’s part of their culture, or if it’s something they think may have affected them. See every new piece of information as an opportunity to learn and to be a better therapist. Hopefully, your patients will be finding new information and growing through their interactions with you. You should be as well. You can always learn something from someone.
7. Research outside work hours
You only have so much time in your office, and your clients are dealing with their mental illness 24/7. If you want to provide the best care to racially different clients, you have to familiarize yourself with their culture. Learn what gestures/sayings may be important to them. If they are bilingual, try learning an important phrase in their language. You and your client may cringe if you mispronounce it, but that shared humorous experience can be a bonding point. It humanizes you and makes you easier to deal with and open up to.
8. One Size Does Not Fit All
This is a topic that’s hard to talk about in a mere 1200-word article. The topic of racial sensitivity, bias, and respect can, and has, filled numerous volumes of literature. Especially within the medical sphere. However, if therapists want to deliver the best care they possibly can, then their client’s culture has to be an active consideration, not an afterthought.