how to be culturally sensitive working with clients with a range of identities

culture defines almost every aspect of our lives: how we nourish our families, how we respond to trauma, how we build our community networks. when traveling abroad, it’s easy to see how cultural boundaries take shape across geographic barriers. but these differences also manifest in communities with diverse populations — people of all different backgrounds living in a shared environment.

sharing space with people from other cultures is more than tolerating each other’s customs; it’s valuing and affirming the ways people from different backgrounds enrich each other’s lives.

this might seem obvious, but when faced with the reality of communities burdened by hate crimes and discriminatory care from providers, there’s much to be addressed in the way of social distance and cultural sensitivity.

a lack of cultural sensitivity has resulted in “embodied inequality.” epidemiologist nancy krieger explains that people who feel marginalized or at risk of discrimination may experience poorer health outcomes throughout their lifespans, through no fault of their own.

— elizabeth brondolo, phd, in a release from the apa.

in fact, threats from social and cultural groups against communities of color have historically led to life-threatening and often fatal outcomes that destroy feelings of safety and belonging.

a report from the american psychological association indicates that people with low incomes and from racial or ethnic minority groups are more likely to experience severe stress than high-income or white counterparts. this stress leads to poorer mental and physical health outcomes for people who are then less likely to pursue medical care because of financial access or fear of discrimination from a provider.

“disparities in both stress and health may not be visible to those who have more advantages or who have relatively limited direct contact with those affected,” said elizabeth brondolo, phd, in a release from the apa. “a well-informed community is critical to improving the health of racial/ethnic and poor communities.”

therefore, it’s important for providers to step outside their own experience and perspective, to consider the  reasons why these instances of cultural insensitivity may lead to poorer health outcomes:

cultural sensitivity requires a set of skills for affirming diversity and embracing the values of people from different social or cultural backgrounds.

previously, many clinicians have referred to this concept as “cultural competency,”  but evolutions in language and inclusivity have called for a more considerate description. plainly put, approaching a person’s care as simply a level of competency can be dehumanizing.

people aren’t lists, and caring for their unique needs is not a matter of completing a task or checking a box. their needs and experiences continue long after they leave a social work or medical office. expressing cultural sensitivities is part of addressing the continuum of care.

becoming educated about different cultures can help providers make more accurate medical or mental health diagnoses and build long-lasting, trusting relationships with clients or patients.

when the culture of an organization is built on principles of diversity, inclusion and affirmation, it’s easier to attract employees and clients who value these traits. service providers and caregivers can actively engage in behaviors that show clients they are valued, heard and understood. this includes looking inward to reflect on biases, according to a report on cultural awareness published in the journal of medical ethics.

self-reflective questions for providers to ask themselves

• in what ways am i privileged?
• how is my lens different from my client’s?
• have i identified my client’s specific needs?
• am i making any assumptions about my client?
• how can i meet my client where they are?
• how might the way i physically interact with people affect my client?
• how do i know my client understood what i said?
• what can i learn from each person i meet?
• where do i have room to grow in my cultural understanding of my clients?
• how can i develop a better understanding of clients who have different identities than me?

strategies to build trust with clients

clinicians can also make use of empowering strategies for helping clients feel understood and accepted. the national education association’s diversity toolkit offers helpful tips:

• use inclusive language in written and verbal discussions.
• ask each client for their preferred pronouns, even when you feel sure of their gender. normalizing the concept of preferred pronouns can help communities become more aware and accepting of gender-nonconforming people.
• take time to learn proper pronunciation of each person’s name. if you’re unsure of how to pronounce a name, ask a client to pronounce it for you instead of guessing.
• ask for permission before touching or hugging each person, regardless of age, gender or ability. this helps clients feel they have agency and protection over their personal space and physical contact.
• learn cultural customs about eye contact, physical contact and hand gestures as they pertain to any community or group with whom you are working closely.
• encourage clients or patients to bring a family member to accompany them in a private room or office.
• offer to translate information or rewrite it at an easier reading level for anyone who may have difficulty reading or understanding complex medical information.
• know the names of cultural or diversity-related organizations in your community to connect others with or refer clients to for more help.

pitfalls providers should avoid

. don’t be defensive when corrected about cultural terms, customs or expectations.

. don’t demand or expect clients to educate you on their culture or customs. go out of your way to research and learn about your community members and their needs.

. don’t take clients’ defensiveness personally in many clinical scenarios, clients or patients may feel less empowered or comfortable opening up.

in any professional organization, always talk to managers and human resources professionals to better understand best practices that are endorsed by the company.

learn more on supporting immigrants and refugees in our collected resources guide.

last updated: april 2020