Bridging Gaps Through Culturally Congruent Care

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This post was co-authored by Kaitlin Lord and Jessica L. Borelli

Have you ever felt like you couldn’t connect with a therapist? Like they just weren’t clicking with you, or understanding your perspective? If so, it might have been because that therapist didn’t adapt their practice to meet your unique needs.

This misalignment could occur, for example, if a therapist doesn’t understand your culture’s common family values and customs (e.g., everyone dropping everything to come greet a family member who returns home from a big trip). Unfortunately, this is a particularly frequent experience for clients of color, and one that can lead them to stop attending therapy. On a more hopeful note, clients of color are more likely to keep going to therapy when the practice is adapted to values and beliefs.

Adapting mental health care can take different forms. A mental health counselor may recognize your cultural background and how it affects your daily lifestyle. A therapist may learn about your values and incorporate them in your treatment. Culturally competent practitioners recognize that mental health care is not one-size-fits-all and adapt their practice to work better for the unique needs of their clients, including their clients of color.

Culture in Therapy: Let’s break down the terminology

There are several different ways to be responsive to a client’s cultural needs.

Cultural competence is the ongoing effort to comprehend, appreciate, and interact with people from backgrounds that are different than your own. Culturally competent practitioners intentionally learn about and respect their patients’ cultures, including their values, traditions, and beliefs. If they begin working with a client from a background that is unfamiliar to them, they will seek out information about the client’s cultural heritage and values by consulting more knowledgeable colleagues, reading up on the topic, and possibly even asking the client for guidance. The therapist may strive to learn about various facets of a client’s cultural identity, including their race and ethnicity, gender, religious background, sexuality, and socioeconomic status.

Culturally congruent care refers more specifically to the interaction between the practitioner and the client. Responding in a culturally congruent manner refers to the dynamic process of adapting care for clients’ unique needs. Because there can be variation within individual cultures, culturally congruent care allows practitioners to “think globally” and “act locally." In other words, these practitioners understand common aspects of their clients’ cultures and value their clients’ individuality. For instance, a therapist might read about the construct of family within their client’s culture and ask their client about their unique family structure, the role that family plays in their life, and so on.

This process of continually tailoring one’s approach based on the client is important as it avoids stereotyping.

Unsurprisingly, culturally congruent care enhances client outcomes and strengthens the therapeutic alliance between the practitioner and the client. These benefits have been found to be especially relevant for clients of color.

Treatment: How to make it congruent with cultural values

While training clinicians in cultural competence is essential for creating culturally congruent care, it is also important to make existing evidence-based treatments congruent. This allows clients to benefit from vetted therapeutic resources. Fortunately, existing treatments and interventions can be adapted to meet the needs of specific groups. Experts have worked to culturally adapt many common treatments, such as cognitive behavioral therapy, dialectical behavior therapy, parent-child interaction therapy, and attachment-based therapies like relational savoring. Cultural adaptations to existing treatments have been widely found to support the well-being of clients of color.

How are existing treatments adapted? One way is through community partnerships, through which experts collaborate with agencies that offer critical insights about the groups they represent. Another method involves conducting interviews with professionals, clients, and or community members to learn from different perspectives and develop tailored interventions that meet the culturally unique needs of a specific group.

While many different treatment programs have been adapted in various ways to align with the cultural values of clients of color, the work is far from complete. Experts continue to explore how mental health care that is congruent with the cultural values of clients of color impacts their experiences and outcomes. Other lines of research expand this focus beyond clients of color, exploring the effects of adapting care for the needs of other minoritized groups, such as LGBTQIA+ folks.

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Wishing your therapy was more culturally competent?

If you don’t yet have a therapist, seek recommendations: Talk to your friends, family, and community members or utilize online resources from groupls like The Trevor Project, Latinx Therapy, the Black Emotional and Mental Health Collective (BEAM), and the Asian Mental Health Collective.

If you already have a therapist, ask them about the Cultural Formulation Interview to discuss your culture in a structured way. Also, talk about your culture with your therapist, sharing about your family, important traditions, religious practices, eating habits, hobbies, and other practices and beliefs that are significant to you. Your therapist should be interested in this part of your experience. And always advocate for yourself with your therapist, providing feedback on what is working well for you and what may not be a good fit for your needs.

To find a therapist, visit the Psychology Today Therapy Directory.