July 27, 2022

By Christa Butler, MS, LPC, RPT-S and

People at counseling
No person or profession is immune from the impact of the broader culture, and our culture was originally structured to support white, male privilege — thus, the professional world continues to suffer from bias and privilege. Counseling is no exception. Good intentions are not enough. Even the sincerest counselors run the risk of harming clients if they don’t practice introspection, unlearning and relearning ways to be more culturally sensitive and equitable.  

There are many ways to draw from treatment approaches that extend outside the traditional structure created by and for people from dominant cultures, and to foster healing in ways that are meaningful for each unique client. Through this process, we can center our approach around honoring one’s cultural, racial and intersectional identities. This work also entails honoring the need for collective healing, connection and community.  

To be inclusive, it’s vital to serve clients with an approach that is culturally affirming and acknowledges their intersectional identities, unique healing traditions and practices specific to the client’s culture. 

Encouraging Connection to One’s Culture

A very important part of being inclusive is honoring ancestral and cultural practices within the healing process, and verbalizing support for the ways someone finds hope and healing within their culture and community.  This includes encouraging participation in culturally specific practices and activities that clients personally enjoy. Keep in mind that people in a specific cultural community are unique, and there’s no one activity that will work or fit everyone.

Adapting Treatment Approaches

The work to be culturally responsive is no easy task and there is no simple formula for getting this right. Every client we work with will require us to change things up in how we communicate with them and adapt their treatment experience to what works best for them.  

A few ways counselors can adapt is by receiving training on how to use expressive therapeutic techniques, like art, music, play and movement. Also, by embracing telehealth to reach clients who may otherwise lack access to culturally sensitive care. 

Using Culturally Competent Language

When it comes to fostering effective advocacy and creating meaningful social change, we cannot underestimate the power of the words we use along the way. Language shapes our perception of the world. Thus, it allows us to shape our world with how we think and speak.

When counselors use terms that resonate with their clients’ experiences and validate their identities, clients are more likely to feel safe, truly seen and valued. Without this sense of safety and respect, therapists and clients cannot develop an effective therapeutic rapport.

A few techniques counselors can use include:

  • Use person-first language, for example, by saying “a person with bipolar disorder, rather than “a bipolar person." This is important because no one is defined by a diagnosis.  
  • Learn about the client’s community and their community’s history, collective experiences, and preferences. For example, practitioners will want to be familiar with the various terms and definitions of sexual orientations and gender identities — and they should avoid using umbrella terms (such in the case of American Indian Tribes) that erase the nuances of race and ethnicity. 
  • Avoid stigmatizing and biased language — specifically, terms that have been identified as ableist, fatphobic and harmful to people experiencing substance use disorders.  

Understanding the Mind-Body Connection

Using psychoeducation about the somatic impact of our experiences, especially trauma and oppression, and learning about body-based healing approaches and interventions that honor the mind-body connection. Creative and expressive forms of therapy (like art and music therapy) and incorporating breathwork and movement in therapy sessions create opportunities for clients to reconnect with their bodies and emotions.  

Acknowledging and Addressing Bias

Healing cannot begin until the counselor has worked with the client to address racist biases and prejudices and acknowledged the nuanced ways clients of color have internalized beliefs that enable and/or add to their own experiences of oppression. Counselors should explore the impact of their client’s acceptance of negative stereotypes about their racial group, which can cause psychological distress and perpetuate harm. Reclaiming and celebrating one’s racial and intersectional identities is one step toward dismantling internalized oppression. 

As we expand our awareness and interrogate how biases have shaped our language, interactions, beliefs, values and decision-making — we must replace negative stereotypes with empathy, connection and community. 

Practicing Lifelong Learning and Humility

While we’ve shifted our notion of “cultural humility” to go a step further to being “culturally responsive,” humility should absolutely remain a priority as we also focus on our responsive actions. No one can ever be an expert in a culture they do not hold membership in, so staying humble and committed to life-long learning is imperative. Making mistakes and acknowledging how we ourselves have participated in oppressive practices is uncomfortable. Through our discomfort and wrestling, we shed what we need to and open ourselves up for opportunities for something much better. Connection over perfection is the goal. 

The call to action in serving others within a culturally responsive framework requires going above and beyond to listen, reflect, unlearn, reeducate and act. Cultural competence is not enough to do the job of treating clients within a framework that truly honors their cultural and intersectional identities. Going above and beyond means doing your own work to confront and unlearn your own bias and prejudices. It is accepting that we all have internalized racial biases and commitment to “I don’t see color” does nothing to further social justice.  See color, see differences, see how we are alike and see beauty in a diverse community.  

 
 

Christa Butler, MS, LPC, RPT-S is a Licensed Professional Counselor, Registered Play Therapist Supervisor, Nationally Certified TF- CBT Therapist and a Virginia Board of Counseling approved supervisor. She serves as the Professional Counseling Issues Specialist in the Center for Counseling Practice, Policy, and Research at the American Counseling Association. Christa has worked in mental health, mostly as a psychotherapist, for over a decade. She most enjoys working with children and families with the integration of play, creativity, art-based and sand tray therapies in combination with evidence-based models. Her current passions are nature-based therapies and decolonization to wellness.
 

Emily St. Amant, MA, LPC-MHSP, AS is a Licensed Professional Counselor and Tennessee Board of Counseling approved clinical supervisor. She serves as the Counseling Resources and Continuing Education Specialist in the Center for Counseling Policy, Practice, and Research at the American Counseling Association. Emily has 15 years of experience in a variety of settings in mental health and has worked as a psychotherapist and in substance use treatment. Her current passion and focus is advocating for and supporting her fellow licensed professional counselors.

Submit To The NAMI Blog

We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices. Check out our Submission Guidelines for more information.

LEARN MORE

NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).