I completed my PhD in social work in 2014. My dissertation measured the relationship between self-compassion and cultural competence: as in, does having more compassion for myself make me better at working with clients whose culture is different from my own? (See Gottlieb & Shibusawa, 2020.)

    Though the answer was (happily) yes, I felt confined by the term “competence.” The meaning and role of our cultures is ever-evolving as we and the society around us change, and to me it seemed an oversimplification to suggest that I could ever pronounce myself competent in that shifting complexity. The concept of cultural competence was often used from an unspoken place of “centeredness,” implying that it was only the client’s cultures that were foreign or different and in need of greater understanding, never our own. There was little mention of how our own cultural landscape impacted the relationship.

    In looking for a more fitting concept, I found a few articles—mainly from other disciplines—on a newer term, cultural humility. What they seemed to have in common was this notion of being teachable—that in order to practice with the greatest amount of respect, I needed to be open to the possibility that what I thought was true or right might not be the whole story. I read everything I could on the subject, and I spent the next two years writing an article that combined literature review with definition and practical application (Gottlieb, 2020). The present piece offers a summary of the concept’s definition and its principles, with some practical applications.

Defining Cultural Humility

    From my perspective, it was imperative that the term “culture” be conceptualized to accommodate every identity that is significant to us or to our clients, including skin color, race, ethnicity, religion, body size, socioeconomic status, sexual identity, gender identity, age, family constellation, caregiver status, citizenship status, addiction history, trauma survivorship, ability, and beyond. With a definition of culture this inclusive, every relationship becomes cross-cultural in some way. Even a client who seems so much “like us” has identities that we do not hold, and every client we perceive as different will ultimately have some identities we share.

    The word humility is defined by Merriam-Webster as “freedom from pride or arrogance; reflecting, expressing, or offered in a spirit of deference.” The Cambridge Dictionary states that humility is “the feeling or attitude that you have no special importance that makes you better than others.” Approaching our clients with humility, as will be further described, asks us to walk alongside our clients, to learn from them as the experts on their own lives, and to be willing to discover where our own identities have shaped our views of what is “normal,” “healthy,” or “right.”

The Principles of Cultural Humility

    1. Commit ourselves to an ongoing process of compassionate self-awareness and inquiry, supported by a community of trusted and cognitively-diverse colleagues.

    This first principle encompasses two equally important aspects of cultural humility. First, we make a commitment to continually exploring our own cultural identities, including how society has valued them and how we have internalized those values, and to question how our identities impact our beliefs as well as the stereotypes and biases we hold. No matter how well we know ourselves, who we are will always influence our relationships. It will strengthen some and make others more challenging. The concept of the practitioner as a “blank slate” or a mirror is impossible—we bring ourselves into every relationship we enter. Examining our cultural identities with compassionate curiosity, rather than being critical of what we find, encourages us to remain open, to keep learning, and to be more conscious and intentional in how our identities inform our work.

    We have all received subtle and overt messages regarding how identities are valued in the societies we inhabit. Even if nothing was ever mentioned about a particular culture, that silence holds meaning. Our first thoughts about a person or situation are involuntary and not necessarily what we truly believe—they are reflections of what we learned from the various social systems in which we were raised. Part of the process of cultivating cultural humility is having the courage to examine these first thoughts—not to judge them, but to develop a critical consciousness, to acknowledge when our ideas are based in stereotypes or generalizations. Over time, we become better able to question our first thoughts, less reactive to them, and we develop an increased capacity to be more intentional in our response.    

    Part two of this first principle—to seek others’ perspectives—can be a challenging aspect of practicing cultural humility. Each of us has areas of “unconscious incompetence,” in which we do not know what we do not know. In these situations, only another person can bring this not-knowing to our awareness. Having people around us who can respectfully challenge our thinking affords us the wisdom of differing perspectives. To exist only in relationships with like-minded individuals is to remain inside a bubble of our own unquestioned biases. By practicing cultural humility within a cognitively-diverse community, we create respectful thinking environments with others who experience the world from differing vantage points.

    2. Be open and teachable.

    Strive to see cultures as our clients see them, rather than as we have come to know or define them. The second principle is the willingness to be a “student of the client.” It asks us to prioritize the client’s perspective and experience, rather than imposing our own story and meaning. What is “normal” to me may not be what is normal for my client. Notions of success, health, family, love, and so many others are culturally-influenced, and we have a much greater chance of assisting our clients (and of their continuing to work with us) when we make the effort to understand their perspective. We discover that together, we find solutions we would not have conceived of alone, solutions that are a better fit with the client’s abilities, resources, and needs.

    A related aspect is having the willingness to admit when we have made a misstep, whether with colleagues or clients. To be teachable means to be open to making mistakes, even to welcome them as part of the learning process. We cannot grow without taking risks, and we cannot take risks without making mistakes. One of our roles with clients is that we model how to be human, in all its vulnerability and imperfection. Our offer of a sincere apology may be the first time they have witnessed someone accepting responsibility for a wrongdoing, which can be transformational in its own right.

    3. Always bear in mind the social structures that have helped shape reality as our clients experience it.

    One of social work’s greatest strengths is the integration of a systems perspective. None of us exists in a vacuum. Our behavior, beliefs, and perception of ourselves and others are inextricably bound to and shaped by our environment. To practice cultural humility means to always consider the ways that the systems with which our clients interact have shaped their lives, their belief systems, their relationships, their sense of self, and the conditions that have brought them to our services. In addition, it asks that we recognize the power dynamic present in the system—whether real or perceived—between ourselves and the person with whom we are speaking, and do whatever we can to equalize it.

    Cultural humility asserts that none of us is exempt from having biases. Each of us learned the perceived value of our own and others’ identities from the social systems we inhabit, be they our families, our education systems, the media, and so forth. We all have areas of conscious and unconscious bias that we can strive to uncover in order to expose the ways we have been taught to judge ourselves and each other. Cultural humility asks each of us to undertake a very personal, individual journey with open curiosity and without shame or blame. There is no finish line to this process—merely an ongoing exploration that is deepened every time we have the courage to place ourselves in new situations or relationships that challenge our beliefs.

    One caveat that I made in the article is one I make here, as well: the theory presented in this paper is inevitably limited—by my own present identities, perspective, and social location, as much as by the current zeitgeist within social work and beyond. My hope is that this theory will be useful and one day supplanted by something even more respectful, collaborative, and socially-just.

    Beyond all the theories we learn, research indicates that the success of a therapeutic bond depends most on the relationship built between ourselves and our clients. Cultural humility offers a guide for that relationship—to continually learn about ourselves, our clients, and the social systems around us; to maintain a willingness to be open and teachable; and to allow ourselves to be transformed by relationships in ways we cannot foresee.

References

Gottlieb, M. (2020). The case for a cultural humility framework in social work practice. Journal of Ethnic & Cultural Diversity in Social Work, DOI: 10.1080/15313204.2020.1753615

Gottlieb, M., & Shibusawa, T. (2020). The impact of self-compassion on cultural competence: Results from a quantitative study of MSW students. Journal of Social Work Education, 56(1), 30-40, DOI: 10.1080/10437797.2019.1633976

Dr. Mara Gottlieb is President of Talking Changes, an anti-oppression and bias-awareness consulting firm. For more than 20 years, she has run workshops across the country, including serving as a keynote speaker and presenting at NASW conferences. Her programs address subjects ranging from cultural humility to anti-racism advocacy, LGBTQ awareness, teen suicide prevention, and vicarious trauma. Dr. Gottlieb has served as an adjunct professor at the NYU Silver School of Social Work, Smith College School for Social Work, and Southern Connecticut State University. She holds a BA from Brown University and earned her MSW and PhD in social work from NYU.

———————

This article is from The New Social Worker, the social work careers magazine.