Running start … to a great career: Enhancing cultural competence

June 27, 2019

When Tiffany O’Shaughnessy, PhD, started graduate school in 2003, the language about the population now thought of as sexual and gender minorities was completely different. Minority stress was just beginning to be understood. Since then there has been an explosion of research to help psychologists better understand what interventions work with different communities and what they need to do their work effectively, says O’Shaughnessy, now an assistant professor of counseling at San Francisco State with a private practice in Berkeley.

Learning more about the LGBT community is just one aspect of diversity training. The Census Bureau is forecasting that the U.S. will become a “majority minority” by 2043, so psychologists will also have to acquire a deeper understanding of different racial and ethnic groups along with the variations in terms of language and customs within large ethnic groups. It’s also important to be competent when it comes to such factors as age, disability and socioeconomic status.

While most graduate training programs require cultural diversity training, very few states require ongoing continuing education (CE) for practitioners. And an occasional workshop isn’t enough in any event, says Sandra Gray, PhD, past chair of the Nevada Psychological Association’s Diversity Committee and founder of Innovation Behavioral Health Solutions, LLC, in Las Vegas. “Cultural competence isn’t just a training you get certified in,” she says. “You have to be constantly learning.”

Use these tips to enhance your own cultural competence:

• Practice cultural humility. A term coined by Melanie Tervalon, MD, and Jann Murray-Garcia, MD, “cultural humility” means a never-ending commitment to evaluating and critiquing yourself as opposed to mastering a discrete body of knowledge via “cultural competence.” “It’s about an attitude of mindful curiosity instead of, ‘I’ve achieved all I have to know,’” says Jessica L. Binkley, PsyD, a member of the Oregon Psychological Association’s Diversity Committee and a psychologist at the Portland Clinic in Beaverton. “It implies a lifelong, evolving process that requires you to be accountable, engaged and self-reflective.” Instead of feeling defensive when someone calls you out on matters related to diversity, she says, take it as an opportunity to learn. Be willing to admit you were wrong, ask questions and think about how you are privileged or marginalized in all the different domains of your life, she suggests.
• Seek out resources. Consult APA’s guidelines for practitioners, such as the 2017 Multicultural Guidelines: An Ecological Approach to Context, Identity and Intersectionality and the newly updated APA Guidelines for Psychological Practice with Girls and Women (PDF, 497KB), which includes new information on transgender and nonbinary individuals plus information on the intersecting impact of sexism, classism, racism, “sizeism” and other factors. Attend CE sessions at the APA convention or your state psychological association. Try the National Multicultural Conference and Summit, suggests O’Shaughnessy. Most helpful is ongoing dialogue, she adds. She’s part of a social justice book club and a monthly “white allies” conference call sponsored by APA’s Div. 17 (Counseling Psychology), for example.
• Ask for help. If you are working with a patient from a group you have little experience with, seek consultation with a mentor or colleague who has worked more with that population. And although you don’t want to burden patients with the task of educating you, adds Gray, it’s OK to ask them to explain something that comes up in a session. You’re not asking the person to be the “go-to” for information on that specific group, but rather asking how something affects that individual, Gray says.
• Engage with the community. “Any way you can go outside your normal spaces and connect with others — maybe going to a new year’s celebration at a local mosque — will give you broader perspectives,” O’Shaughnessy says.