Montefiore in the News

A culturally competent therapist will be able to understand, appreciate and interact with people from varying cultures or belief systems.   Ruben Castaneda March 31, 2022

Whether you're dealing with anxiety, depression, an eating disorder or post-traumatic stress disorder, finding a therapist that you feel comfortable with and trust can be a challenging proposition. The task can be particularly complex for people of color and LGBTQ individuals.

Cultural competence is “loosely defined as the ability to understand, appreciate and interact with people from cultures or belief systems different from one’s own,” according to a paper published online by the American Psychological Association. This concept has been important in the field of counseling for more than five decades. “It’s become such an integral part of the field that it’s listed as one of psychology’s core competencies,” according to the APA.

A culturally competent therapist “empowers you to share your story at your own pace, is careful to avoid broad generalizations when describing or exploring your experiences and demonstrates comfort when you share aspects of your identity, appearing calm and asking appropriate probing questions,” says Ryan DeLapp, a clinical psychologist with the Montefiore Health System and an assistant professor at the Albert Einstein College of Medicine in New York City. DeLapp has conducted research on issues of cultural competency and therapy.

When she was in graduate school, studying to become a therapist, Christine Oh, a second-generation Korean-American, experienced how a therapist’s lack of cultural understanding could affect a patient firsthand. She was in therapy as a part of her graduate education.

“My therapist was a white male. He was a great therapist, but when it came to my cultural background as it related to my family, I think he didn’t completely understand,” says Oh, who's assistant campus dean with the Southern California campuses for the Chicago School of Professional Psychology.

For example, when she related frustrations she experienced when her parents suggested she didn’t need to go away to graduate school to study to become a mental health professional, Oh was horrified of even a discussion around her not talking to them for a while. Asian culture emphasizes honoring ones parents, she says, so not speaking to her parents did not seem like a realistic option. “What do you mean, cut my parents off?" she says. "That was not on option. That would cause me more trauma.”

A culturally competent therapist would understand that cutting off the patient’s parents – even for a short time – isn’t a viable option, Oh says. Instead, such a therapist would talk with the patient about his or her feelings about their parents’ cultural expectations. The mental health professional might suggest the patient try to talk to their parents about why she wants to pursue higher education as a second-generation Korean-American female instead of getting married and having kids after college, and what it means to be a postgraduate student.

Asian parents typically want their children to go to college, she explains. But at a certain point, many Asian immigrant parents tend to have a double standard for how much education a woman needs after college and prioritize getting married and having kids instead.

It’s important to keep in mind that a therapist need not be of any particular ethnicity, race or gender to be culturally competent. The vast majority of therapists – 86% of all therapists in the U.S. – are white, according to the APA.

Rather, “cultural competence makes cross-culture work possible,” says Frances Chinchilla, a licensed clinical social worker who is a behavioral health therapist and clinical supervisor with AltaMed Health Services in Los Angeles. She is of Guatemalan descent. “A therapist does not have to be of the same cultural background but does need an understanding of the core values held by the culture that a patient identifies with. Simply stated, culture influences what gets defined as a problem, how the problem is understood and which solutions to the problem are acceptable.”

When cultural differences between a patient and a provider are “unacknowledged and unaddressed, these differences have been found to perpetuate disparities through misdiagnosis and mistreatment,” Chinchilla says.

Tips for Finding a Culturally Competent Therapist

Here are three tips for finding a culturally competent therapist:

1. Ask friends and family for referrals.

Your network of friends and relatives can be good sources for finding a culturally competent therapist, says Mayra Mendez, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, California.

“Ask your friends and family, ‘Do you like your therapist? Why does he or she work for you?’” she says. You can ask your friend or family member whether the therapist understands their identity, such as their cultural background.

It’s important to keep in mind that a therapist of any background can, with the right training and experience, be culturally competent; and looking for one that matches your background would be very difficult if you are a person of color, since the vast majority of psychologists in the U.S. are white.

2. Check websites geared toward finding culturally competent therapists.

There are an array of online sources that can help people of diverse backgrounds find a culturally competent therapist relevant to their background. For example, on the website Therapy for Latinx, a search of therapists who specialize in trauma shows almost 430 therapists nationwide who are Hispanic or who have experience working with Latino patients.

Other online resources include:

• Inclusive Therapists, a network centered on the needs of Black, Indigenous and people of color and the LGBTQ community.
• South Asian Therapists, a mental health therapy and counseling directory network for the South Asian diaspora.
• Therapy for Black Girls, an online mental wellness network for Black women and girls.

The websites are similar in providing search options for therapists by geography and specialty. For example, the homepage of the website Inclusive Therapists is written in English and Spanish. Inclusive Therapists has a search tool that allows users to look for therapists in a wide array of specialties, including:

• Family therapy.
• Group therapy.
• Individual therapy.
• Medication management.
• Therapy for children.

Similarly, South Asian Therapists, which is in English, provides search tools that allow a user to look for a therapist worldwide and in a specific city. The website touts itself as the "largest South Asian mental health community in the world."

The website Therapy for Black Girls has a search tool in which the user can look for a therapist for Black women and girls by geography. For example, a search for therapists in the Washington, D.C., region produces nearly 470 therapists within 50 miles, most if not all of whom are Black. You can adjust the search to tighten the geographic range. The website also provides links to an array of blogs on mental health issues, covering topics such as the impact of ghosting on mental health and relationships and how to find joy in everyday life.

Ask therapists you're considering working with for a consultation call or meeting. Some clinicians offer these free of charge, DeLapp says. “Communicate your goals for seeking therapy, and request that the therapist share whether they have expertise consistent with your goals,” he says. “If you do not feel their expertise or a background is a good fit, then request referrals for individuals who share this expertise.”

If you're a consumer looking for a culturally competent therapist, DeLapp recommends asking these questions during a consultation:

• What does it mean to you to provide culturally aware care?
• What training or learning have you done on this topic?
• Can you describe how you try to celebrate your patients' identities during your work with them?
• I'm part of the (name your community); it's an important part of my identity. Are you familiar with this community?
• Have you treated other people who are part of this community in the past? Can you describe ways that you integrated their identity into successful treatment of their symptoms?
• Have you worked with people who wanted to discuss racism, concerns related to exploring identity, discrimination, religion or immigration-related concerns?
• It will be important for me to feel comfortable discussing privilege, racism, discrimination and/or systemic oppression. Is that something you'd welcome or have experience discussing?

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Frances Chincilla, LCSW Chincilla is a licensed clinical social worker who is a behavioral health therapist and clinical supervisor with AltaMed Health Services in Los Angeles.

Ryan DeLapp, PhD DeLapp is a clinical psychologist with the Montefiore Health System and an assistant professor at the Albert Einstein College of Medicine in New York City. DeLapp has conducted research on issues of cultural competency and therapy.

Mayra Mendez, PhD Mendez is a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, California.

Christine Oh, PhD Oh is assistant campus dean, Southern California campuses for the Chicago School of Professional Psychology.

Tags: psychology, mental health, therapy