Cultural Humility in Therapy: What It Is and Why It Matters

By Clay Klaus-Wade ·

The short answer

Cultural humility is a way of approaching therapy that assumes the client, not the therapist, is the expert on their own life and culture. Instead of claiming to already understand someone because of a training or a textbook, a culturally humble therapist stays curious, keeps examining their own assumptions, and pays attention to the power that comes with sitting in the therapist's chair. Cultural responsiveness is what that stance looks like in action: adapting the work to fit who you actually are.

For many people, it's the difference between a therapist who seems to be filling in a form about them and one who's genuinely trying to know them.

Cultural humility vs. cultural competence

For years, the dominant idea in health care was cultural competence: the notion that clinicians could learn enough about different groups to work with them effectively. In 1998, physicians Melanie Tervalon and Jann Murray-García pushed back on that idea, arguing that culture can't be mastered like a finite body of knowledge, and that thinking it can risks turning people into stereotypes (Tervalon & Murray-García, 1998).

They proposed cultural humility instead, built on three commitments:

  • Lifelong self-reflection: continually examining your own assumptions, biases, and cultural identity
  • Addressing power imbalances: recognizing the authority that comes with the clinician's role, and letting people define their own concerns
  • Partnership: building respectful, non-paternalistic relationships with individuals and communities

Knowledge still matters. A therapist should understand the histories, communities, and systems that shape people's lives. But knowledge is a starting point, not a finish line, and it never replaces asking you what something means to you.

What does cultural humility look like in a therapy room?

Psychologist Joshua Hook and his colleagues described cultural humility in therapy as an interpersonal stance that's oriented toward the other person, especially toward the parts of their identity that matter most to them (Hook et al., 2013). In practice, it might look like:

  • Asking how you identify and what your identities mean to you, rather than assuming
  • Making room to talk about race, culture, religion, class, gender, sexuality, disability, and immigration history when they're relevant, and not forcing them when they aren't
  • Noticing and naming differences between you and your therapist, so they don't sit unspoken in the room
  • Owning it when your therapist gets something wrong, and repairing it
  • Understanding that some of what hurts comes from systems, like racism, homophobia, transphobia, or poverty, and not from you

That last point matters. The counseling profession's own standards, the Multicultural and Social Justice Counseling Competencies endorsed by the American Counseling Association, ask counselors to consider how privilege and oppression shape both the client's life and the counseling relationship itself, and to be willing to advocate beyond the therapy room when needed (Ratts et al., via Counseling Today).

Does cultural humility make a difference?

Research suggests it does. A 2018 review of studies on what's called the multicultural orientation framework, which includes cultural humility along with a therapist's ability to notice cultural opportunities and to feel at ease in cultural conversations, found early evidence linking these qualities to stronger therapy relationships, clients' sense of improvement, and fewer racial and ethnic disparities in who drops out of therapy (Davis et al., 2018).

That makes sense to me. People can usually tell whether they're being seen as themselves or as a category, and that sense shapes everything that follows.

Culturally responsive therapy at Layered Health

Layered Health is a Philadelphia-based psychotherapy practice opening in Summer 2027. My work is grounded in cultural humility and liberation-minded care, with a particular commitment to affirming LGBTQ+, consensually non-monogamous, and neurodivergent people, and to understanding each person through the many layers that make them who they are.

If you're looking for a culturally responsive therapist in Philadelphia, I'd love to hear from you.

Contact me

Frequently asked questions

What is cultural humility in therapy?

Cultural humility is an approach in which the therapist treats the client as the expert on their own culture and identity, stays curious, examines their own biases, and pays attention to the power dynamics in the therapy relationship.

What's the difference between cultural humility and cultural competence?

Cultural competence suggests a clinician can master knowledge about different groups. Cultural humility treats learning about culture as a lifelong process that centers the individual client's experience and the clinician's ongoing self-reflection.

What does a culturally responsive therapist do?

A culturally responsive therapist asks how you identify, makes room to discuss culture and identity when relevant, names differences in the room, repairs mistakes, and understands how systems like racism and homophobia affect mental health.

Does cultural humility improve therapy outcomes?

Early research suggests it does. Studies have linked therapist cultural humility and related qualities to stronger therapy relationships and clients' sense of improvement.

Sources