This article is written with mental health and healthcare providers in mind. If you’re not a provider, you’re still welcome to read along; just know the content is tailored to a clinical perspective.
Weekly Education Talks is a blog series from Rivia Mind highlighting clinical perspectives and evolving topics in mental health care. This article is based on a three-part presentation by Erin Jackson, LCSW, and reflects our commitment to evidence-based, relationship-centered care for every provider and patient.
The following vignette is fictional and does not describe a real patient.
Layla sat quietly in the parenting group, arms folded across her chest.
She was of Middle Eastern descent, 32 years old, married, and caring for two young children at home. She had been referred through the court system. Her materials noted no indication of marital discord and only a slight possibility of unexplored trauma.
She and other parents had been gathering weekly in a structured, group-based program grounded in child–parent psychotherapy. Participants discussed why they had been referred, explored parenting concerns and emotional triggers, and practiced attachment-based tools.
Layla stood out. She was guarded, her nonverbal communication defensive. She appeared angry and confused about why her parenting was being questioned. She also presented as depressed, anxious, and afraid. Layla didn’t respond to questions; her husband answered for them both. When she did speak, she was articulate. There was no indication that she lacked the capacity to participate in the course.
The disconnect created tension for the clinician facilitating the group. Why wasn’t Layla using her voice? She noticed her attention shifting. Silence paired with deferral can activate concerns about power, coercion, or safety. Her focus moved away from the parenting content and toward Layla’s nonverbal cues, scanning for signs of harm.
During a break, the clinician approached Layla privately and asked if she was okay, explaining why the question had come up. Layla looked surprised. Then she laughed. There was no harm or coercion, she explained. This was her culture. Deferring to her husband in public spaces was a sign of respect. He was viewed as the leader of the household, and this dynamic was not experienced as silencing but as alignment.
Had the clinician led with an assumption, Layla’s quiet presence could have been documented as nonparticipation. Her deference could have been framed as resistance. A report might have reflected minimal engagement or lack of progress — conclusions that would have followed Layla beyond the room.
Instead, cultural humility interrupted the reflex to interpret. Curiosity slowed the process enough to prevent a misread. Layla remained present in the group on her own terms, rather than being filtered through someone else’s frame.
How Culture Shapes Clinicians
Culture doesn’t just describe our patients. It shapes us, too.
It shows up in small, ordinary ways: the food we grew up eating, the music that feels familiar, the holidays we celebrate, the way we were taught to react to confrontation. It influences how we socialize, work, regulate, and understand emotional expression. Those influences don’t disappear when we become clinicians.
They shape what we notice, question, and assume. They impact how quickly we label something “avoidant,” “defensive,” or “concerning.” And they inform how we decide what needs intervention and what doesn’t. This is why cultural humility determines how accurately we understand the people sitting in front of us.
When we are self-aware about our own cultural lenses, we gain clarity about where we’re limited. Patients feel that difference immediately. They know we’re interested in more than symptom checklists when we’re actually trying to understand who they are in the full context of their lives.
What Constitutes Culture — Clinically Speaking
Culture reflects a person’s way of life. It includes beliefs and moral frameworks, religion, ethnicity, sexual orientation, family structure, political alignment, communication style, and socioeconomic context. These elements shape how people understand authority, express distress, tolerate uncertainty, and engage with systems of care.
What matters clinically is not simply that culture exists, but that it varies across all people. Patients bring their cultural frameworks into the therapy room. When those frameworks are ignored or misread, behavior can be pathologized unnecessarily.
What Cultural Humility Asks of Us
Cultural humility begins where certainty often takes over.
It is not a checklist of cultural facts or an expectation that clinicians become experts in every identity, tradition, or lived experience. It is an ongoing practice of self-reflection — noticing how our beliefs, training, and implicit biases shape what we see, question, and conclude.
Cultural humility asks us to pause before we decide what something means. It asks us to recognize when assumptions are filling in gaps. And it asks us to provide care that makes sense within the cultural reality a patient is living, rather than one we unconsciously project onto them.
For clinicians, this is not abstract. It directly affects assessment, documentation, engagement, and safety decisions.
Cultural Humility in Daily Clinical Practice
What practice looks like today is not what it looked like ten years ago — and it will not look the same ten years from now. Patients change. Contexts shift. The social, political, and cultural environments people live in evolve constantly. Practicing with cultural humility means accepting that reality and leaning into its fluidity.
In daily work, this shows up as open-mindedness, willingness to examine bias, and active curiosity about difference. The National Association of Social Workers defines cultural humility as the ability to identify our own cultural affiliations while recognizing and respecting differing traditions in others, particularly as they influence communication and expressions of respect.
These differences are easy to misinterpret if we’re not attentive. In some cultures, direct eye contact shows consideration; in others, it does not. In some contexts, extending a hand is appropriate; in others, it isn’t. Cultural humility doesn’t require mastery of these norms, but does require awareness that our default interpretations aren’t universal.
Core Principles of Cultural Humility
Cultural humility can be anchored by three practical commitments that shape how we learn, consult, and engage clinically.
1. Ongoing Compassionate Self-Awareness and Inquiry
Cultural humility requires a foundational commitment to self-reflection and curiosity, supported by trusted, diverse colleagues.
None of us practices in isolation. Our clinical judgment sharpens through consultation, dialogue, and exposure to perspectives that challenge our own.
When we use our colleagues as resources, we become better equipped to serve our patients. We can share information, challenge one another thoughtfully, and pull from a wider range of clinical lenses than we could access alone. Drawing from varied experiences allows us to interrupt blind spots and expand the range of interpretations available to us.
2. Openness and Teachability
Being teachable is a clinical skill.
It means resisting the urge to defend what we already know. It requires flexibility to pivot as new information emerges, research evolves, or patient experience contradicts our assumptions. Not knowing is not a failure of competence; it is an invitation to learn.
Follow curiosity. When something captures our interest, we can choos
3. Awareness of Social Structures
Cultural humility asks us to keep social structures plainly in view.
This means looking beyond presenting symptoms and asking deeper questions. Where did this person learn how to manage distress? What cultural influences shaped their coping strategies? How do social, economic, familial, or historical contexts influence how they respond to authority?
Doing this allows us to engage patients as whole people and defer to them as the experts on their own lives.
What Culturally Humble Engagement Looks Like
Reflection Without Defensiveness
We all carry bias. The breakdown happens when we pretend it doesn’t influence our thinking.
Culturally humble engagement requires openness to critique and readiness to adjust when assumptions interfere with trust, safety, or connection.
Curiosity as a Clinical Tool
We are never going to be experts in every culture or lived experience.
Curiosity does the work that expertise cannot. Asking what matters and why often reveals more than interpretation ever could. For newer clinicians, curiosity is also practical. When you’re unsure what to ask next, culture is a meaningful place to look.
Power Is Already in the Room
Patients often experience clinicians as experts, and that power differential shapes what feels safe to disclose or challenge.
Acknowledging this — even implicitly — reduces the assumption of deficit that authority can create. It communicates something essential: you are the one who matters in this room; we are here to support and guide, not override. That shift alters engagement, especially for patients who are used to people pleasing or holding back around authority figures.
Holding Culture and Safety Together
Cultural humility does not mean ignoring risk.
Two things can be true at once: cultural norms can shape behavior, and safety concerns may still warrant attention. Curiosity allows exploration without accusation. Creating space for disclosure requires availability. Sometimes that looks like visible resources or a carefully timed check-in, other times it’s about being direct and asking the question.
How This Elevates the Work
When we practice this way, our work becomes more accurate.
We move beneath the surface sooner because patients feel understood. Communication improves. Power dynamics soften. Retention increases. Most importantly, cultural humility reinforces a core truth of mental health care: patients are the experts on their own lives.
We bring tools, frameworks, and perspectives, but those tools only work when they are offered in ways that honor lived experience.
Cultural humility is not an extra layer of care. It shapes how we assess, document, interpret, and intervene — supporting patients’ goals with integrity and sharpening our understanding of their world.
Resources
- National Association of Social Workers. Standards and Indicators for Cultural Competence in Social Work Practice.
- Child Welfare Information Gateway. Practicing Cultural Humility.
- Gottlieb, M. (2021). The Case for a Cultural Humility Framework in Social Work Practice. Journal of Ethnic & Cultural Diversity in Social Work, 30(6), 463–481. https://doi.org/10.1080/15313204.2020.1753615
- Project Implicit. Implicit Bias Test.
