What Cultural Humility Means in Mental Health Care

Key Takeaways

• Cultural humility is an ongoing approach to care that emphasizes reflection and learning rather than mastery.
• Cultural humility helps build trust in therapy by focusing on understanding and respect instead of making assumptions about someone's background.
• Cultural humility supports more equitable mental health care across settings, including online therapy environments.
  

A Black woman tells her therapist she doesn't trust healthcare professionals after years of dismissive care. Instead of exploring this fear, the therapist insists that therapy is different and pushes forward. Cultural humility could have shifted this entire interaction, especially when someone's already dealing with a mental health challenge or high levels of stress.

Cultural humility means committing to ongoing self-reflection and recognizing power imbalances in therapy instead of claiming to be an expert on any one culture. It shifts mental health care from knowledge acquisition to relational partnership.

Therapists stay curious, acknowledge their biases, and let the people they work with guide them. This approach works especially well in virtual therapy, where people from varied backgrounds connect with providers they might never meet locally. When practiced well, therapy becomes a collaborative space built on respect, not assumptions.

What is Cultural Humility?

Cultural humility is an approach to mental health care that prioritizes ongoing self-reflection and awareness of power within the therapeutic relationship. It describes a lifelong commitment to self-evaluation and to addressing power imbalances within the therapeutic relationship.

The concept was introduced in the late 1990s by Melanie Tervalon and Jann Murray-García in Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education, published in the Journal of Health Care for the Poor and Underserved.

At its core, cultural humility emphasizes process over mastery. There’s no certification or final level to reach. Instead, clinicians continually examine how their identities, assumptions, and social positions shape the therapeutic space.

Cultural Humility vs. Cultural Competence

While cultural competence and cultural humility are closely related, they differ in focus, mindset and how they shape therapeutic relationships. The table below outlines the key distinctions between cultural competence and cultural humility.

Why competence can fall short

Competence-based models can unintentionally encourage oversimplification. Learning about a group's “typical” beliefs or behaviors can slide into stereotyping, even when intentions are good. Mental health care happens at the individual level, not at a cultural checklist level that treats culture as a set of traits rather than lived experience.

Power of self-reflection and lifelong learning

Cultural humility emphasizes the clinician's internal growth, encouraging self-awareness of biases and an openness to correction. This mindset leads to more compassionate, responsive, and ethical care in diverse settings.

Why Cultural Humility Matters in Mental Health Care

Cultural humility helps build stronger therapeutic relationships by shaping how trust develops, which is essential for understanding the therapy process and staying engaged in care.

This approach strengthens the therapeutic alliance, which directly affects how well therapy works. The same skills also help therapists improve their practice, especially when working with people whose backgrounds and experiences differ from their own.

Cultural humility plays a vital role in helping individuals feel seen and valued in care. Prioritizing representation in therapy helps build trust and encourages engagement, especially for those who have felt overlooked or misunderstood in healthcare settings.

Cultural competence gave me knowledge, but cultural humility transformed my relationships by shifting me from expertise to genuine partnership. When clients feel experienced rather than interpreted, trust deepens and the work becomes more honest and effective. Dr. Cynthia Catchings, Talkspace Therapist

Four Core Principles of Cultural Humility

In practice, cultural humility shows up through specific principles that guide clinical decision-making and therapeutic relationships. Many of these principles align with qualities people often associate with a good therapist, particularly self-awareness and responsiveness to an individual’s lived experience.

The following principles form the foundation of culturally humble care:

1. Lifelong commitment to self-evaluation and critique

Clinicians maintain an ongoing practice of reflection that helps them notice how their perspectives influence care. This involves regularly questioning assumptions and staying open to feedback when something does not land as intended. Over time, this level of self-awareness supports more responsive and ethical clinical decisions.

2. Addressing power imbalances in the individual-therapist relationship

Therapy inherently involves power, shaped by professional authority and access to resources. Cultural humility asks providers to acknowledge that dynamic openly and to work in ways that invite collaboration rather than control. Transparency around roles and decision-making can help create a greater sense of safety and trust.

3. Developing non-paternalistic partnerships

Individuals are experts in their own lived experience, even when seeking guidance or support. Cultural humility prioritizes working alongside people rather than directing them toward predetermined outcomes. When goals and meaning are developed collaboratively, treatment is more likely to feel relevant and respectful.

4. Institutional accountability

Organizations influence care through training standards, policies, and workplace culture. Cultural humility extends beyond individual clinicians, calling on institutions to examine how systems support or hinder equitable care. Accountability at this level helps ensure that humility is sustained rather than left to personal intention alone.

Step-by-Step Practice Framework for Clinicians

Practicing cultural humility requires intention during everyday clinical work. The following steps offer practical ways clinicians can apply a humility-based approach before, during, and after sessions:

1. Intentional self-check-ins before sessions

Taking a brief pause for self-reflection before a session can help clinicians notice the assumptions or expectations they may be carrying into the room. Even a few moments of reflection can shift the focus from problem-solving to understanding. Over time, this practice helps clinicians remain present and responsive rather than reactive.

2. Using open-ended questions

Open-ended questions invite members to share meaning in their own words rather than fitting their experience into predefined categories. Thoughtful inquiry encourages nuance and allows values and beliefs to emerge naturally during the session. When clinicians ask with curiosity instead of certainty, members often feel more respected and understood.

3. Repairing cultural missteps

When an assumption misses the mark, acknowledging it directly helps restore trust. Repair is part of cultural humility and signals respect for the therapeutic relationship. For people who have experienced feeling misunderstood in therapy, this kind of response can make the difference between withdrawing from care and staying engaged.

A common cultural microaggression in therapy is assuming a client’s values, family roles, or experiences based on their race, culture, or identity, which can subtly invalidate their lived reality. A humility framework supports repair by encouraging the clinician to acknowledge the impact, invite correction, and re-center the client as the expert on their own experience, thereby restoring trust and safety in the therapeutic relationship.

- Talkspace Therapist, Dr. Cynthia Catchings, PhD, LCSW-S

Real-World Cultural Humility Examples in Action

Cultural humility becomes clearer when viewed through everyday therapy interactions. In practice, it shows up in small decisions about language, pacing, and curiosity that signal respect for a person’s lived experience rather than assumptions about what support should look like.

The following examples illustrate how cultural humility shapes authentic therapeutic moments:

Navigating religious and spiritual beliefs about mental health

An individual might describe their depression as a spiritual test or punishment for past wrongs. A culturally humble therapist doesn't immediately reframe that belief or label it as avoidance.

Instead, they explore how those beliefs affect coping and introduce mental health support in ways that align with the person's values. This keeps trust intact while still addressing safety and providing effective care.

Understanding collectivist versus individualist values in treatment goals

Some members approach therapy with a strong focus on family responsibility or community harmony. A therapist practicing cultural humility resists imposing individual-centered goals and instead asks how wellness is defined within that person’s relational context.

Treatment planning may focus on communication and boundaries, or stress management, in ways that respect those values. When care reflects what matters most to the member, engagement often improves.

Addressing the impact of historical trauma in therapy

Healthcare trust may not come easily for people whose communities have experienced displacement, systemic violence, or long-standing discrimination. Cultural humility recognizes this hesitation as protective rather than resistant.

Therapists may slow the pace of treatment, explain decisions more transparently, and allow the relationship to develop gradually. Honoring context in this way helps create a sense of safety without forcing vulnerability before someone is ready.

Common Barriers and How to Overcome Them

Clinicians often cite fear of "saying the wrong thing," limited time, or defensiveness as barriers to effective care. However, cultural humility shifts the perspective, viewing mistakes as valuable opportunities for learning and building stronger connections, rather than as personal failures.

When supported by proper training and a nurturing organizational culture, this approach becomes sustainable and transformative.

Quick Self-Assessment Checklist

Cultural humility develops through consistent self-reflection, not just completing a workshop. The following questions encourage therapists to examine how their own perspectives and power influence their daily clinical work:

• When was the last time I examined a bias that showed up in session?
• Do I invite members to define what respect means to them?
• How do I respond when corrected?
• Whose goals drive treatment decisions?
• What systems influence my clinical choices?
• How do I continue learning outside formal training?

Asking these questions regularly keeps humility active rather than theoretical. When self-reflection becomes routine, therapy becomes more responsive to the people it's meant to serve.

Moving Forward: Committing to Culturally Humble Care

Cultural humility transforms mental health care by keeping relationships at the center. It supports ethical practice and helps care providers better reflect the realities of diverse lives. But this work doesn't fall only on therapists. People seeking care also benefit from knowing what culturally humble therapy looks like.

Finding the right therapist often means looking for someone who listens without jumping to conclusions, respects your background, and stays open to learning. Online therapy with a licensed therapist removes common barriers like distance, limited therapists in your area, or rigid schedules that make it harder to connect with someone who truly fits.

Talkspace connects you with licensed therapists who approach care with curiosity and respect. You deserve therapy that feels like a partnership, where your therapist grows with you. Get started with Talkspace and find someone who practices cultural humility from your first session onward.

Frequently Asked Questions

How is cultural humility different from cultural competence in mental health care?

Cultural competence focuses on learning facts about different cultures through training and education. Cultural humility takes a different path by emphasizing ongoing self-reflection and recognizing power dynamics in therapy. Instead of assuming they understand someone's culture after reading about it, therapists stay open to learning directly from each person. This shift keeps curiosity alive and prevents assumptions from replacing meaningful understanding.

Can cultural humility affect the success of therapy?

Cultural humility can influence how safe and understood a person feels in therapy. When therapists remain open and responsive, trust tends to grow more naturally over time. This trust supports engagement and makes it easier to work through challenges together. A stronger connection often leads to better outcomes and longer-term participation in care.

What does cultural humility look like in a therapy session?

Cultural humility shows up in how a therapist listens and adapts in real time. When something doesn't land right, the therapist acknowledges it instead of getting defensive. Curiosity replaces assumptions, and the person in therapy gets to guide how their experience is understood.

Why is cultural humility important in online therapy?

Online therapy connects people from vastly different backgrounds who might not meet in the same physical space otherwise. Without being in the same room or seeing someone's surroundings, therapists can miss important context and jump to conclusions more quickly. Cultural humility helps them slow down, ask clarifying questions, and pay attention to how meaning comes across in a virtual setting. This makes care feel respectful and responsive, even from a distance.

How can clients promote cultural humility in their mental health care?

People in therapy play an important role by sharing what feels supportive and pointing out moments that feel off. Speaking openly about your identity and what you need from therapy helps guide the process. Learning how to talk to a therapist can make those conversations easier to start, especially if you're not used to speaking up about what's working or what isn't.

Sources:

1. Tervalon, M., & Murray-García, J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved. 1998 May; 9(2): 117-125. https://pubmed.ncbi.nlm.nih.gov/10073197/. Accessed January 15, 2026.

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