Cultural Competency in Mental Health Treatment

A lack of cultural competency amongst mental healthcare providers can be a barrier to treatment, especially for patients from marginalized communities.

For mental health providers, cultural competency means the ability to provide services that recognize and appreciate the cultural differences between the patient and therapist. In other words, the more a provider knows and respects a patient’s background and values, the more likely that person will feel comfortable during treatment.

What’s considered “normal” can vary between provider and patient but greatly impact diagnosis, treatment, and prognosis. When mental health professionals accommodate and respect the differences in opinions, values, and attitudes of marginalized people, including communities of color and LGBTQ+ communities, patients are less likely to be misdiagnosed and more likely to continue treatment. Cultural competency is especially important when considering that an individual’s perception of mental health, including stigma, is often influenced by their cultural identity and social values.

May is Mental Health Awareness Month, and in recognition of the event, Anu Raj, Psy.D., clinical psychologist at the Center for Behavioral Health and co-chair for New York Tech’s Diversity, Equity, and Inclusion (DEI) Task Force, shares tips for finding a culturally competent mental health provider.

The United States is a nation full of diversity—of race, ethnicity, ability, and sexual and gender orientation—and it’s growing more diverse every year. Given this, the need for culturally competent providers seems urgent. Does research also indicate this?
Yes. In recent years, there has been an abundance of research supporting the need for culturally competent mental health providers. These include studies from the American Psychological Association, Frontiers in Public Health, and Journal of Mental Health Counseling, just to name a few.

Many recent studies demonstrate how a culturally competent approach impacts therapeutic alliance and rapport, which is a central factor in therapeutic success. Rapport requires trust in the process and is seen as the stepping stone to emotional healing.

Place of birth, where or how a patient was raised during their formative years are the basis of that person’s approach to the world and emotional self. As such, a culturally aware clinician will account for the patient’s unique values and cultural norms in their treatment approaches.

How can someone find a culturally competent therapist?
The best ways are to:

• Follow the therapists’ media comments: social media posts, academic contributions, blogs, training, etc.
• Research the regional psychological associations in your area. Many of these associations list mental healthcare providers with specific areas of expertise, and those providers with specific training in cultural competence typically ensure that their training is highlighted in their professional profile.
• The American Psychological Association (APA), like many regional associations, also lists diversity-trained psychologists. Many of these lists are detailed in levels of cultural competence levels. The APA also has a Psychologist Locator, which allows users to find a provider who specializes in a particular area, including ethnicity, religion, sexual orientation, etc.

Is word of mouth a good approach?
Word of mouth is always a good approach. It generally means previous patients found the provider practiced awareness of cultural nuances and incorporates those aspects in treatment. The only caveat is that there is no such thing as one-size-fits-all in psychology. Each person’s psychological growth and need is different from others, and similarly, each psychologist’s growth and relationship with cultural competence is different. Word of mouth may be a good beginning, but each person needs to vet and assess their therapist for their personal needs.

What does cultural competency training look like for most psychologists?
There is an emphasis on cultural competence during placement supervision (often termed as externships and one-year required internships). Each case conceptualization includes psychopathology and normative behavior along with the societal impact on behavior; this is where cultural issues are raised and addressed. In addition, part of our doctoral training emphasizes research methodology where bias and prejudice are addressed. Our profession’s research aspect of training looks into bias from the researcher and the subject’s perspectives. We are taught about historical cases of biases and prejudices in our ethics classes. Part of our oath, which is often addressed in our ethics classes, includes cases of bias where we are asked to engage in Socratic thinking and discussions. Furthermore, there are questions related to cultural competency included in our licensure exams, so training and knowledge of these factors are needed.

For license renewal, we are required to review and pass ethics courses where cases of inclusion and equity are included. Several malpractice companies offer monetary benefits for extra course completions in the areas of Ethics and Cultural Competence. Many states are looking into mandating cultural competency-related continued education credits for license renewal. Given that each state has its own rules, there is no uniformity in state-mandated continued education for license renewal.

This interview has been edited and condensed.