The Difference Between Cultural Competence And Cultural Humility

While finding a therapist can be a little daunting, finding one who also understands your background and culture can be an additional hurdle. A good fit with your therapist is the most important factor in your treatment, so finding a culturally competent therapist has long been the aim of therapy-seekers of certain races, ethnicities, or other identities looking for the best therapist for them.

The argument has been made, however, that simply being culturally competent might not be enough. Cultural humility, which is emerging as the preferred term, goes farther than competence. So what’s the difference between cultural competence and cultural humility and which one is more important?

What is cultural competence?

The National Institute of Mental Health defines cultural competency as “the behaviors, attitudes, and skills that allow a health care provider to work effectively with different cultural groups.” Basically, it means that if your therapist or coach has a different background or identity than you, they could attempt to learn about your background, identity, and culture in order to provide you with appropriate care.

However, the issue with cultural competency stems from the implication that one could “achieve” competence in another culture—and be content to stop there. It could be understood as gaining just enough knowledge about another culture that you are merely competent and implies that cultures are monolithic or unchanging, which is untrue. Knowing about one community does not make us culturally competent about all communities. Additionally, communities are dynamic and change over time.

Some argue that cultural competency is either impossible (there’s no way to become competent in another culture because you don’t have that lived experience) or that it’s not enough to be merely competent.

To some, culture humility might be both a better term and a better aim while to others, the concepts are not either/or but both/and—one should strive for both cultural competence and cultural humility.

So what is cultural humility?

Cultural humility is a process of reflection and lifelong inquiry that involves self-awareness of personal and cultural biases as well as awareness and sensitivity to significant cultural issues of others. The idea of humility comes from the fact that the focus should not be on competence or confidence and recognizes that the more someone is exposed to cultures different from their own, the more often they will realize how much they don’t know about others.

In a 1998 article on which most of the discussion about cultural competency versus cultural humility is based, Dr. Melanie Tervalon and Dr. Jann Murray-García suggested not only that cultural competency be distinguished from cultural humility, but that cultural humility was a more suitable goal than cultural competence. They defined three points that describe cultural humility:

• A lifelong commitment to self-evaluation and self-critique: One never arrives at a point where they are done learning. Therefore, people must be humble, flexible, and bold enough to look at themselves critically and desire to learn more.
• A desire to fix power imbalances where none ought to exist: Recognize that each person brings something different to the table and see the value of each person. When practitioners interview clients, the client is the expert on their own life, symptoms, and strengths. While a therapist has knowledge that the client does not, the client also has a body of knowledge and understanding outside the scope of the practitioner. Both must collaborate and learn from each other for the best outcomes.
• Aspiring to develop partnerships with people and groups who advocate for others: Though individuals can create positive change, communities and groups can also have a profound impact on systems. We cannot individually commit to self-evaluation and fixing power imbalances without advocating within the larger organizations in which we participate. Cultural humility, by definition, is larger than our individual selves—we must advocate for it systemically.

Why is having a culturally competent or culturally humble healthcare provider important?

As the world becomes increasingly diverse and multicultural, health care providers have been encouraged to become aware of cultural differences and their impact on health.

Your culture can play a huge part in:

• your mental and physical health
• your views of mental health treatment
• the way you communicate your needs to your healthcare providers
• the way you interpret communication from your healthcare providers
• the way you might be treated by healthcare providers

The National Association of Social Workers even states the importance of cultural competence and cultural humility in their Code of Ethics. Social workers should:

• Demonstrate understanding of culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.
• Demonstrate knowledge that guides practice with clients of various cultures and be able to demonstrate skills in the provision of culturally-informed services that empower marginalized individuals and groups, while also taking action against oppression, racism, discrimination, and inequities, and acknowledging their own personal privilege.
• Demonstrate awareness and cultural humility by engaging in critical self-reflection, recognizing clients as experts of their own culture, committing to lifelong learning, and holding institutions accountable for advancing cultural humility.
• Obtain education about and demonstrate understanding of the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical ability.

A therapist or coach who is not committed to the components of cultural humility—a lifelong commitment to self-evaluation and self-critique, a desire to fix power imbalances, and the aspiration to develop partnerships with people and groups who advocate for other—might not have the mindset to provide the best care possible for someone from a different background.

How can I find a therapist or coach who is culturally competent and/or culturally humble?

Again, a good fit with your therapist or coach is the most important factor in the success of your care, so finding the right match for you is key (while keeping in mind that your own needs may change over time and a therapist or coach who is a good fit for you right now might not be the best match for you down the line—and that’s okay!). The best course of action is to do some reflection about what is important to you and then some research by leaning on your community and other resources like:

• Word of mouth and recommendations from friends, loved ones, and other people in your community.
• Agencies or organizations who build communities for and serve people with your identity or cultural background that have directories or would be able to connect you with therapists who could be a good fit.
• Websites and social media profiles of your potential therapist or coach. Are they using culturally competent language and images? Do they have a statement or testimonies on their site about their success with people who have different backgrounds and identities? Just like you might research a potential employer, research the public profile of your potential therapist or coach.
• Matching services like MyWellbeing will ask about topics you’d like to explore, such as race-related stress, immigration, cultural competence, spiritual crisis and transition, social justice, and trauma. We also ask about the preferred identity of your therapist, including their gender and whether or not they identify as a person of color or LGBTQIA+, and we ask you to rank the importance of these factors in your search.

Whether we’re talking about cultural competence or cultural humility, there are a few questions you can ask your therapist or coach to see if they might be a good fit for you:

• Do you have experience treating people with my identity or cultural background?
• What training have you had in cultural competency and what are your thoughts about cultural humility?
• Do you have familiarity with my culture’s attitudes toward mental health treatment?
• Are you willing to learn about aspects of my culture and identity that you aren’t familiar with?
• How would you include my identity, race, age, religion, gender identity, etc. in my care and treatment plan?

Remember that it’s not your responsibility to teach your therapist—they have their own responsibility to be culturally competent, culturally humble, and knowledgeable about different cultures and intersectional identities themselves.

“Therapists that provide culturally competent care will have an ongoing process of developing awareness and knowledge of client's racial and ethnic identity development, cultural strengths and values, and experiences with stigma, prejudice, and discrimination,” says Ernesto Lira de la Rosa, a New York City therapist and MyWellbeing community member. “It is through this process that we are able to modify and adapt our clinical interventions so they are culturally sensitive for our clients.”

By continually learning and working on cultural competency and incorporating cultural humility as a lifelong practice, your therapist or coach can demonstrate their responsibility and dedication to seeing and valuing the diversity of their clients and offering you the support you deserve.