Cultural humility in helping work
You don’t have to know everything about someone’s culture. You do have to stay curious, open and willing to learn.
By the numbers
What research says about culture in the helping room.
In the room
The workforce
What is cultural humility?
A lifelong stance of learning, not a box you tick.
Cultural humility was first described by physicians Melanie Tervalon and Jann Murray-García in 1998. They defined it as a lifelong commitment to self-reflection and self-critique, to fixing power imbalances between helper and client, and to building respectful partnerships with communities.
Psychologists later described it as an interpersonal stance that is other-oriented rather than self-focused, with respect for and no sense of superiority toward a person’s cultural background.
Read more
Tervalon and Murray-García argued that treating cultural knowledge as a finite body of facts to master is not the right goal. Humility means always learning.
Read more
Professional standards describe culture as including race and ethnicity, but also language, religion and spirituality, sexual orientation, gender identity and expression, age, ability, immigration status and social class.
Everyone has a culture, including you. Identities also overlap, and which ones matter most can change over time and setting.
Read more
The NASW standards name cultural humility as part of cultural competence, alongside self-awareness. The APA Multicultural Guidelines describe competence as a lifelong process that includes cultural humility.
Humility and competence: both matter
Knowledge helps. Openness makes it useful.
Some people set cultural humility against cultural competence. Most professional bodies now treat them as partners. Knowledge and skills are useful, and humility keeps them from turning into stereotypes.
Research shows why humility matters. Across 15 studies, clients’ ratings of their therapist’s cultural competence were strongly linked with outcomes. Therapists’ ratings of themselves were not.
Read more
In four studies, clients who saw their therapist as culturally humble reported a stronger working alliance. They also reported more improvement, and the stronger alliance helped explain why.
Read more
The ACA framework has four developmental areas: counselor self-awareness, the client’s worldview, the counseling relationship, and counseling and advocacy interventions. Each includes attitudes and beliefs, knowledge, skills and action.
Read more
APA’s 10 guidelines ask psychologists to see identity as fluid and layered, to recognize their own attitudes and biases, to attend to language, context, power and privilege, and to take a strength-based approach.
Knowing your own lens
Your identities, values and blind spots shape every session.
APA’s second guideline says helpers are cultural beings too, with attitudes and beliefs that can shape how they see people and what they conclude about them.
The ACA Code of Ethics asks counselors to be aware of, and avoid imposing, their own values, attitudes and beliefs, and to seek training where they are at risk of doing so.
Read more
The ACA framework uses four pairings to show how privileged and marginalized identities on both sides shape the relationship: privileged helper with marginalized client, and every other combination.
Read more
When a client’s choices surprise you or make you uneasy, pause and ask where that reaction comes from. It may say more about your background than about theirs.
Read more
Questions to ask yourself
- What do I assume about family, independence or success?
- Which ways of showing emotion do I see as healthy?
- Who might feel unwelcome in my waiting room or forms?
- Whose idea of “help” is built into my service?
Asking, not assuming
Inviting culture into the conversation, on the person’s terms.
The APA guidelines note that paying attention to which identities a client says are most important, rather than relying on the helper’s assumptions, matters for both the process and the outcomes of therapy.
“Broaching” means openly inviting conversation about culture and identity. Clinicians writing about cultural ruptures recommend it alongside a humble stance, to lower assumptions and the chance of misunderstandings.
Read more
Try
- “How do people in your family or community talk about stress or feelings?”
- “Is there anything about your background you’d like me to understand?”
- “Some people find it matters that we have different backgrounds. How is that for you?”
- “What parts of who you are feel most important right now?”
Read more
Avoid
- Asking someone to speak for their whole group
- Assuming beliefs or values based on appearance or a name
- Avoiding culture entirely because it feels awkward
- Making people educate you before you’ve done your own learning
Read more
Avoiding cultural topics was one of the most common microaggressions clients reported in counseling.
Microaggressions, missteps & repair
Everyone gets it wrong sometimes. What matters is what happens next.
In a study of 2,212 racial and ethnic minority clients, 81% reported at least one racial microaggression in counseling. The most common involved denying or not noticing stereotypes and bias, and avoiding cultural issues.
Clients who saw their counselor as more culturally humble reported fewer microaggressions. Differences between helper and client can raise the chance of a rupture, and ruptures that go unrepaired can lead people to leave care.
A simple repair
- Notice: a pause, a change in tone, or a client going quiet.
- Name it gently: “I wonder if what I said didn’t land well.”
- Listen without defending or explaining your intentions.
- Own the impact and apologize simply.
- Ask what would help, and adjust.
- Reflect later, in supervision or on your own, on what you learned.
Language, interpreters & access
People can’t benefit from help they can’t understand.
The National CLAS Standards from the U.S. Department of Health and Human Services ask services to offer language help at no cost, tell people it is available, and provide easy-to-understand materials in the languages used locally.
The standards say interpreters should be competent, and that using untrained people or minors to interpret should be avoided. The ACA code likewise asks counselors to arrange a qualified interpreter or translator when needed.
Read more
The CLAS standards advise against relying on untrained people or minors to interpret.
Family members may soften, leave out or add to what is said, and clients may hold back private things in front of them. Children should not be put in the position of interpreting hard news or personal topics.
Read more
Tips
- Brief the interpreter beforehand on the topic and any sensitive content
- Check in with the interpreter afterwards, since they hear hard stories too
- Speak directly to the client, not to the interpreter
- Use short sentences and pause often
Read more
Communication needs include sign language, braille, plain language and support for people with lower literacy.
History, mistrust & fair assessment
Respecting the past, and checking bias in how we judge.
The APA guidelines describe “cultural mistrust”: people from groups that were exploited by medical, mental health or research systems may bring a justified skepticism. Validating that mistrust and talking openly about it can strengthen the relationship.
The ACA code asks counselors to recognize that culture affects how problems are defined and experienced, and to be aware of historical and social prejudices in how some groups have been misdiagnosed or pathologized.
Read more
APA’s guidelines ask psychologists to use culturally appropriate methods in assessment, interpretation, diagnosis and research.
Questions to ask
- Am I reading a cultural norm as a symptom?
- Could language or education level affect the results?
- Was this tool tested with people like this client?
- Would I reach the same conclusion for someone from my own background?
Read more
The APA guidelines encourage respecting and including local and culture-specific healing practices, and learning from cultures rather than only about them.
Humility in supervision & teams
Culture shapes how colleagues treat each other too.
In a study of 102 supervisees of color with White supervisors, more frequent racial microaggressions in supervision were linked with a weaker supervisory relationship and lower satisfaction with supervision.
Teams that look different from the communities they serve can miss things. In 2019, 83% of U.S. psychologists were White, and the NASW standards include building a diverse workforce as one of their ten standards.
Read more
Ideas
- Bring up culture and identity early, before a problem arises
- Invite feedback on how supervision feels for the supervisee
- Name your own identities and how they may shape your views
- Repair quickly and openly when you get it wrong
Read more
The CLAS standards ask organizations to train leaders and staff regularly on culturally and linguistically appropriate services.
Ideas
- Ask people served for feedback, in their own language
- Check whether outcomes or drop-out rates differ by group
- Include community members in planning
- Support staff from minoritized groups without overloading them with “diversity” tasks
Community, advocacy & keeping it going
How community helps, beyond the one-to-one.
Tervalon and Murray-García included partnerships with communities in their original idea of cultural humility. The ACA framework adds advocacy, from the individual level out to communities, institutions and public policy.
Read more
Faith communities, cultural centers and community organizations often have trust that services have to earn. Partnering with them, on their terms, can make help easier to reach.
Read more
APA’s guidelines ask psychologists to understand power, privilege and oppression and to address institutional barriers to fair, quality care.
Read more
APA’s tenth guideline calls for a strength-based approach that builds resilience within people’s cultural context.
Read more
Ideas
- Join a consultation group focused on culture and identity
- Learn about the communities in your area from their own writers and leaders
- Read work by authors from backgrounds different from yours
- Revisit your identity map once a year
When and where to get help
Support for helpers, especially those facing bias themselves.
Helpers from minoritized groups may face bias from clients, colleagues or systems while also supporting others through the same experiences. That load is real, and it deserves support.
Where to start
- Talk with a supervisor, mentor or colleague you trust.
- Look for peer groups or professional associations for people who share your identity.
- Contact your employee assistance program if you have one.
- Find a therapist of your own, including one who shares parts of your identity if that matters to you.
- Talk with your clinical provider about your health.
- Call or text 988, or chat at chat.988lifeline.org, any time you need to talk to someone right now.
You can also text HOME to 741741 to reach the Crisis Text Line, free and 24/7 in the U.S. Outside the U.S., findahelpline.com lists free, confidential helplines in many countries.
📝 Worksheets for this guide
Fill these in privately in the app. Your answers stay on your phone.
Sources
- Journal of Health Care for the Poor and Underserved (via PubMed) (1998). Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education (Tervalon M, Murray-García J)
- Journal of Counseling Psychology (via PubMed) (2013). Cultural humility: measuring openness to culturally diverse clients (Hook JN, Davis DE, Owen J, Worthington EL, Utsey SO)
- Journal of Counseling Psychology (via PubMed) (2016). Cultural humility and racial microaggressions in counseling (Hook JN, et al.)
- Journal of Clinical Psychology (via PubMed) (2018). Cultural adaptations and therapist multicultural competence: Two meta-analytic reviews (Soto A, Smith TB, Griner D, Domenech Rodríguez M, Bernal G)
- American Journal of Psychotherapy (via PubMed) (2025). Repairing Cultural Ruptures in Psychotherapy: Strategies to Enhance the Therapeutic Alliance (Boswell N, et al.)
- Journal of Counseling Psychology (via PubMed) (2024). Cultural humility and racial microaggressions in cross-racial clinical supervision: A moderated mediation model (Wilcox MM, et al.)
- American Psychological Association (APA) (2017). Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality
- American Counseling Association (ACA) / Association for Multicultural Counseling and Development (2015). Multicultural and Social Justice Counseling Competencies (Ratts MJ, et al.)
- National Association of Social Workers (NASW) (2015). Standards and Indicators for Cultural Competence in Social Work Practice
- U.S. Department of Health and Human Services, Think Cultural Health. National Culturally and Linguistically Appropriate Services (CLAS) Standards
- American Counseling Association (ACA) (2014). 2014 ACA Code of Ethics
- U.S. Census Bureau. American Psychological Association Uses ACS Data to Identify Need for Mental Health Services, Education, and Training
- 988 Suicide & Crisis Lifeline. 988 Suicide & Crisis Lifeline
- Crisis Text Line. Crisis Text Line
- ThroughLine. Find A Helpline
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.
