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Cited by 34Counseling Practices and SupervisionCultural Competency in Health CareRacial and Ethnic Identity Research

Cultural humility and cultural competence in counseling: An exploratory mixed methods investigation

Open access
Zhu, Peitao, Luke, Melissa M., Liu, Yanhong, Wang, Qiu·2023·Journal of Counseling & Development
DOI 10.1002/jcad.12469
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Abstract

Using an exploratory sequential mixed methods research design, we investigated the relationship between cultural humility (CH) and cultural competence (CC), two concepts that have been widely discussed in the multicultural counseling literature. We first adopted a thematic analysis to explore how 14 experienced counselor educators perceived the CH–CC relationship and identified three preliminary themes. Then, we utilized quantitative analyses to test the hypotheses derived from the qualitative themes, based on a sample of 434 adults who received mental health services. Both qualitative and quantitative results supported that CH and CC (a) share conceptual alignment; (b) emphasize on different aspects of counselor characteristics and behaviors in cultural contexts; and (c) both play an integral, yet slightly varied, role during the counseling process. We discuss implications regarding embracing CH and CC in the counseling practice, counselor educator, and future research on multicultural counseling.

AI snapshot

Written from the paper’s full text.

TL;DR

This exploratory sequential mixed methods study examined how cultural humility (CH) and cultural competence (CC) relate in counseling. It found that client-rated CH and CC are strongly aligned but distinguishable, and both predict therapeutic working alliance, with CH adding a small amount of unique prediction.

Key findings

  • Qualitative themes from 14 experienced counselor educators indicated that CH and CC overlap and align, focus on different counselor characteristics/behaviors, and that CH complements CC in multicultural counseling.
  • In the quantitative sample of 434 adults who received mental health services, CHES and CCCI-R7 total scores correlated strongly, \(r = 0.85, p < 0.01\), sharing approximately 72% of variance.
  • CFA results supported related but distinct factor structures: a four-factor model fit adequately, \(\chi^2 = 1151.04, df = 588, p < 0.001\), RMSEA = 0.047, CFI/TLI = 0.930/0.930, SRMR = 0.047.
  • In PLS-SEM predicting working alliance, CCCI-R7 alone accounted for 60.3% of variance; adding CHES increased explained variance by 3.2% as a global factor and 3.7% as three subfactors. CCCI-R7 and CHES were both significant positive predictors, though not all CHES subfactors were independently significant.

Methods

  • Exploratory sequential mixed methods design with two studies: Study 1 used reflexive thematic analysis of 28 interview transcripts from 14 counselor educators with at least 10 years of professional experience and multicultural/cross-cultural expertise.
  • Study 2 used a cross-sectional, correlational quantitative design with 434 adults aged 18+ who were currently receiving or had received counseling/psychotherapy from a licensed professional or allied professional and had completed at least three sessions.
  • Measures included the client-rated Cultural Humility and Enactment Scale (CHES), Cross-Cultural Counseling Inventory-Revised 7-item version (CCCI-R7), and Working Alliance Inventory-Short Form Revised (WAI-SR); analyses included bivariate correlations, confirmatory factor analyses, and partial least squares path modeling.

Limitations

  • The paper states that Study 1’s counselor educators had high education and disciplinary-specific knowledge that may not reflect client participants or generalize broadly to clients; thematic analysis is interpretive, so researchers’ prior work and conceptual lens inevitably shaped theme identification.
  • The paper states that Study 2’s cross-sectional correlational design cannot establish causality or track perceptions over time; MTurk samples may be younger, more educated, and less politically and religiously diverse than the general population, limiting generalizability; data were collected before COVID-19 and related social unrest, so external validity is uncertain.
  • The paper states that CHES was newly developed and CCCI-R7 had not been extensively utilized, so measurement issues may have affected results; it also notes that the additional variance explained by CHES was small (3%–4%) and not all CHES subfactors were independent significant predictors beyond CCCI-R7.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/jcad.12469

Cites

47 of 47 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 33 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Most participants shared that they immediately resonated with the notion of CH during their first encounter.

    “Although CH is relatively new term compared to CC, most participants (e.g., Participants 2, 4, 5, 6, 11, 12, 13, and 14) shared that they immediately resonated the notion of CH during their first encounter.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Participants perceived CH as prioritizing cultural awareness over knowledge and skills.

    “In comparison, adopting CH seems to mean prioritizing cultural awareness over knowledge and skills.”
    Quote in the paperSubstantial claim
  • Findingown data

    Participants pointed out that both CH and CC highlight the importance for counselors to engage in continued self-growth to better serve culturally diverse clients.

    “Most saliently, participants pointed out that both concepts highlight the importance for counselors to engage in continued self-growth to better serve culturally diverse clients.”
    Quote in the paperSubstantial claim
  • Findingown data

    Many participants expressed that CH and CC align on the core notion of respecting and honoring differences in cultural values and backgrounds.

    “Many participants also expressed how CH and CC align on the core notion of respecting and honoring differences in cultural values and backgrounds.”
    Quote in the paperSubstantial claim
  • Findingown data

    Most participants referenced the tripartite MCCs model in differentiating CH from CC.

    “Most participants referenced the tripartite MCCs model in differentiating CH from CC.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 29
  • Classified as probably not a substantial claim. 19
  • The quote only partly states this claim. 4

  • May combine two claims.

    Findingown data

    CH and CC both play an integral, yet slightly varied, role during the counseling process.

    “Both qualitative and quantitative results supported that CH and CC (a) share conceptual alignment; (b) emphasize on different aspects of counselor characteristics and behaviors in cultural contexts; and (c) both play an integral, yet slightly varied, role during the counseling process.”
    • Also stated in: § Findings · plain
      “We identified three themes based on our analysis of the data: (a) CH overlaps and aligns with CC; (b) CH and CC focus on different aspects of counselor characteristics and behaviors; and (c) CH complements CC in multicultural counseling.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    Participants believed that CH complements CC through a critical attitude toward and utilization of cultural knowledge.

    “Another way, participants believed CH complements CC involves a critical attitude toward and utilization of cultural knowledge.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Many participants emphasized that adopting CH leads to critically examining the cultural contexts from which knowledge is generated, identifying underlying assumptions and biases, and evaluating potential impact of applying it in a clinical context.

    “Therefore, many participants emphasized that adopting CH leads to critically examining the cultural contexts from which the knowledge is generated, identifying the underlying assumptions and biases embedded within such knowledge, as well as evaluating the potential impact of applying it in a clinical context.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Counselor educator participants in Study 1 believed that CC focuses more on acquiring and demonstrating culturally relevant knowledge and skills, whereas CH emphasizes embodying a sense of curiosity and developing an ability to critically examine cultural knowledge.

    “For example, counselor educator participants (Study 1) believed that CC focuses more on acquiring and demonstrating culturally relevant knowledge and skills, whereas CH emphasizes on embodying a sense of curiosity and developing an ability to critically examine cultural knowledge.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    CHES total scores and WAI-SR total scores were significantly correlated (r = 0.76, p < 0.01).

    “All correlations were significant at the 0.01 level (2-tailed).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    CCCI-R7 total scores and WAI-SR total scores were significantly correlated (r = 0.78, p < 0.01).

    “All correlations were significant at the 0.01 level (2-tailed).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In Prediction Model 2b, CCCI-R7 (β = 0.44, CI = [0.32,0.56], p < 0.001), CHES Factor B (β = 0.09, CI = [0.02,0.16], p = 0.013), and CHES Factor C (β = 0.24, CI = [0.11,0.36], p < 0.001) were significant predictors of WAI-SR with small effect sizes, whereas CHES Factor A (β = 0.09, CI = [-0.002,0.20], p = 0.074) was not a significant predictor.

    “The results showed that the CCCI-R7 (β = 0.44, CI = [0.32,0.56], p < 0.001), CHES Factor B (β = 0.09, CI = [0.02,0.16], p = 0.013), and CHES Factor C (β = 0.24, CI = [0.11,0.36], p < 0.001) were significant predictors of the WAI-SR with small effect sizes, whereas the CHES Factor A (β = 0.09, CI = [-0.002,0.20], p = 0.074) was not a significant predictor.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The additional variances explained by the CHES in this study were small (3%-4%), similar to Hook et al. (2013), and not all CHES sub-factors were independent significant predictors beyond the CCCI-R7.

    “Notably, the additional variances explained by the CHES in our study were small (3%-4%), which were similar to Hook et al. (2013), and not all CHES sub-factors were found to be independent significant predictors beyond the CCCI-R7 (Table 4).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hook et al. (2013) source

  • May combine two claims.

    Findingown data

    The CCCI-R7 factor showed a strong correlation with CHES Factor A (r = 0.85, p < 0.001) and Factor C (r = 0.92, p < 0.001), and a moderate correlation with Factor B (r = 0.66, p < 0.001).

    “The CCCI-R7 factor showed a strong correlation the CHES Factor A (r = 0.85, p < 0.001) and Factor C (r = 0.92, p < 0.001), and a moderate correlation with Factor B (r = 0.66, p < 0.001).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Combining CCCI-R7 items with CHES Factor A did not result in an ideal solution, and CCCI-R7 and CHES Factor B only shared a moderate correlation.

    “In contrast, combining CCCI-R7 items with the CHES Factor A did not result in an ideal solution, and the CCCI-R7 and CHES Factor B only shared a moderate correlation.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In Prediction Model 1, CCCI-R7 was a strong significant predictor of WAI-SR (β = 0.78, CI = [0.73,0.81], p < 0.001) with a large effect size (f2 = 1.53, CI = [1.15,0.199], p < 0.001), and the model accounted for 60.3% of the variance in WAI-SR.

    “The CCCI-R7 was a strong (β = 0.78, CI = [0.73,0.81], p < 0.001) significant predictor of the WAI-SR with a large effect size (f 2 = 1.53,CI = [1.15,0.199], p < 0.001), and the model accounted for 60.3% (CI = [0.54,0.67], p < 0.001) of the variance in WAI-SR.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    CHES and CCCI-R7 total scores have a strong correlation (r = 0.85, p < 0.01), sharing approximately 72% of the variance.

    “Specifically, the CHES and CCCI-R7 total scores have strong (r = 0.85, p < 0.01) correlations, sharing approximately 72% of the variance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    AVE and CR values for each factor were: CHES Factor A (AVE = 0.55, CR = 0.94), Factor B (AVE = 0.57, CR = 0.92), Factor B (AVE = 0.63, CR = 0.92), and CCCI-R7 (AVE = 0.64, CR = 0.93).

    “Moreover, we calculated the average variance extracted (AVE) and CR values for each factor: CHES Factor A (AVE = 0.55, CR = 0.94), Factor B (AVE = 0.57, CR = 0.92), Factor B (AVE = 0.63, CR = 0.92), and CCCI-R7 (AVE = 0.64, CR = 0.93).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    A second-order factor CFA model (Factor Model 3) with CCCI-R7 subsuming the three CHES factors showed slightly inferior fit than the four-factor solution but superior fit than solutions with mixed items.

    “The result also showed slightly inferior model fit than the four-factor solution, but superior fit than solutions with mixed items.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The correlation coefficients between the CCCI-R7 and CHES factors were 0.81 for Factor C, 0.79 for Factor A, and 0.60 for Factor B.

    “Furthermore, the correlation coefficients between the CCCI-R7 and CHES factors were 0.81 for Factor C, 0.79 for Factor A, and 0.60 for Factor B.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    CHES total scores and CCCI-R7 total scores were significantly correlated (r = 0.85, p < 0.01).

    “All correlations were significant at the 0.01 level (2-tailed).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    CC is operationalized as counselors' awareness, knowledge, skills, and action to deliver competent counseling services to culturally diverse clients.

    “Within the CH-CC literature, CC is operationalized as counselors' awareness, knowledge, skills, and action to deliver competent counseling services to culturally diverse clients (Drinane et al., 2016;Ratts et al., 2016;Sue et al., 1992)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Drinane et al., 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Ratts et al., 2016 source
    • cites Sue et al., 1992 source

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    CH is defined as counselors' self-reflection, critique, and sensitivity to cultural encounters both dispositionally and situationally.

    “whereas CH is defined as counselors' self-reflection, critique, and sensitivity to cultural encounters both dispositionally and situationally (Davis et al., 2018;Zhu et al., 2022).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Davis et al., 2018 source
    • cites Zhu et al., 2022 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The researchers' prior work and conceptual lens inevitably impacted how themes were identified in the thematic analysis.

    “Moreover, as TA is an innately interpretive process (Braun & Clarke, 2006, 2021), the researchers' prior work and conceptual lens inevitably impacted how themes were identified.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Braun & Clarke, 2006, 2021

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Multiple steps were undertaken to increase the rigor and trustworthiness of the thematic analysis.

    “Multiple steps were undertaken to increase the rigor and trustworthiness of the TA.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The study intentionally sought input from two distinct pools of participants (experts on multicultural counseling literature and clients who received mental health services) across the two studies to ensure that findings had generalizability across research-practice contexts.

    “We intentionally sought input from two distinct pools of participants (i.e., experts on multicultural counseling literature and clients who received mental health services) across the two studies to ensure that our findings had generalizability across research-practice contexts.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The two participant pools (counselor educators and clients) are sufficient to ensure generalizability across research-practice contexts.

  • May combine two claims.

    Premisecitation

    Within all supervision studies, supervisors' CH was found to be related to positive supervisory working alliances, supervisees' increased satisfaction with supervision, and greater supervisee self-efficacy.

    “Within all the supervision studies, supervisors' CH was found to be related to positive supervisory working alliances, supervisees' increased satisfaction with supervision, and greater supervisee self-efficacy (Zhang et al., 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Zhang et al., 2022

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The researchers used an audit trail to address dependability.

    “We used an audit trail to address dependability, detailing the logical, traceable, and transparent processes.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    We were unable to comprehensively assess the converging and diverging dimensions between CC and CH due to the brevity and single-factor structure of the CCCI-R7 and lack of an alternative well-validated client-rated CC measure.

    “Given the brevity and single-factor structure of the CCCI-R7 and lack of an alternative well-validated client-rated CC measure, we were unable to comprehensively assess the converging and diverging dimensions between CC and CH.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All statistical assumptions regarding correlation analyses were examined, including normality, homoscedasticity, and linearity.

    “All statistical assumptions regarding correlation analyses were examined, including normality, homoscedasticity, and linearity.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The researchers engaged in critical self-examination as part of reflexivity.

    “Lastly, we engaged critical self-examination as part of reflexivity to account for our internal and external dialogs (Hays & Singh, 2023).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hays & Singh, 2023

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Cook et al. (2020) found that supervisors' CH effectively mitigated supervisees' intentional nondisclosure.

    “For example, Cook et al. (2020) found that supervisors' CH effectively mitigated supervisees' intentional nondisclosure (a common problem involved in the process of clinical supervision which often results from supervisors' lack of relational sensitivity).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cook et al., 2020 source

  • May combine two claims.

    Interpretationown data

    Counselors who are perceived as culturally humble also tend to be perceived as culturally competent (and vice versa).

    “Taken together, these results seemed to suggest that counselors who are perceived as culturally humble also tend to be perceived as culturally competent (and vice versa)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The shortened CCCI-R7 fit a one-factor solution with high factor loadings (all above 0.63) and demonstrated excellent internal consistency reliability (Cronbach's alpha above 0.90).

    “The shortened CCCI-R7 fit a one-factor solution with high factor loadings (all above 0.63) and demonstrated excellent internal consistency reliability (Cronbach's alpha coefficient above 0.90).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Drinane et al., 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    In the current study, the composite reliability for the CHES total scale was 0.92, and for subscales were 0.94, 0.92, and 0.92.

    “In the current study, the composite reliability (CR) (i.e., multidimensional correlated-factor Omega) for the total scale was 0.92, and the omegas for the subscales were 0.94, 0.92, and 0.92.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductnone given

    The large, national sample in Study 2 was diverse and met all assumptions for the sophisticated analyses undertaken.

    “the large, national sample in Study 2 was diverse and met all assumptions for the sophisticated analyses undertaken”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    All scales and subscales demonstrated acceptable AVE values, excellent Cronbach's alphas, and CR coefficients.

    “All scales and subscales demonstrated acceptable AVE values, excellent Cronbach's alphas, and CR coefficients (Table 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Meta-analyses found that counselor-rated CC did not correlate with treatment outcomes, whereas client-rated CC correlated strongly with treatment outcomes.

    “Meta-analyses found that counselor-rated CC did not correlate with treatment outcomes, whereas client-rated CC correlated strongly with treatment outcomes (Soto et al., 2018;Tao et al, 2015).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Soto et al., 2018 source
    • cites Tao et al, 2015

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The first author served as the primary coder, with the second author serving in secondary roles to triangulate coding, offer divergent perspectives, and disrupt potential biases.

    “The first author served as the primary coder for the TA, with the second author serving in secondary roles to triangulate coding, offer divergent perspectives, and disrupt potential biases.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Interpretationown data

    The CHES, whether entered as a global factor or three sub-factors, increased the predictive power of the model predicting WAI-SR beyond CCCI-R7.

    “The CHES, whether entered as a global factor or three sub-factors, increased the predictive power of the model.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    No issues with the measurement models were detected, as all indicators were significantly loaded on their corresponding factor, with factor loadings ranging from 0.653 to 0.879.

    “No issues with the measurement models were detected, as all indicators were significantly loaded on their corresponding factor, with the factor loadings ranging from 0.653 to 0.879.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    These results supported the convergence of items within each factor but indicated concerns with differentiation between factors.

    “These results supported the convergence of items within each factor but indicated concerns with differentiation between factors (Table3).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    A three-factor solution for the CHES achieved excellent model fit, representing three subscales: cultural teachability, cultural superiority and disrespect, and relational-oriented engagement.

    “A three-factor solution achieved excellent model fit, representing the three subscales: (a) cultural teachability; (b) cultural superiority and disrespect; and (c) relational-oriented engagement.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Zhu et al., 2022 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The researchers used referential adequacy to check preliminary findings and interpretations against the raw data across transcripts.

    “In addition, we used referential adequacy to check preliminary findings and interpretations against the raw data across transcripts (Nowell et al, 2017).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nowell et al, 2017

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Davis et al. (2016) detected a significant mediating role of clients' perceived CH on the effect of negative emotional responses due to therapeutic rupture on their estimated improvement of counseling and perceived working alliance.

    “For example, Davis et al. (2016) detected a significant mediating role of clients' perceived CH on the effect of negative emotional responses due to therapeutic rupture on their estimated improvement of counseling and perceived working alliance.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Davis et al., 2016 source

  • May combine two claims.

    Interpretationown data

    Being culturally humble and competent are both essential qualities of counselors to form a strong therapeutic alliance with clients.

    “additionally, being culturally humble and competent are both essential qualities of counselors to form a strong therapeutic alliance with clients.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The researchers endeavored to minimize the impact of their prior work by adhering to the inductive process of theme generation.

    “We endeavored to minimize such impact by adhering to the inductive process of theme generation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    What differentiates CH from CC may be the orientation to expand one's cultural beliefs and values (CHES Factor A) and to avoid displaying a sense of superiority in implicit and explicit ways (CHES Factor B).

    “However, what differentiates CH from CC may be the orientation (Davis et al., 2018) to expand one's cultural beliefs and values (CHES Factor A) and to avoid displaying a sense of superiority in implicit and explicit ways (CHES Factor B).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Davis et al., 2018 source

  • May combine two claims.

    Study design and conductreasoning

    The cross-sectional correlational design used in Study 2 does not permit the analysis of perception across time or enable claims about causal relationships among the variables.

    “In addition, the cross-sectional correlational design used in Study 2 does not permit the analysis of perception across time or enable claims about causal relationships among the variables.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Participants' qualifications were verified through reviewing their curriculum vitae.

    “Participants' qualifications were verified through reviewing their curriculum vitae.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Results of our studies demonstrated shared conceptual commonalities across CH and CC, and also differentiated CH from CC through the transformative potential and growth processes.

    “Moreover, although results of our studies demonstrated shared conceptual commonalities across CH and CC, they also differentiated CH as from CC through the transformative potential and growth processes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Data from both studies were collected prior to the onset of the novel coronavirus (COVID-19) as well as the concomitant social unrest and exacerbated racial tensions, and it remains unknown if or how these factors could impact external validity.

    “Further, as data from both studies were collected prior to the onset of the novel coronavirus (COVID-19) as well as the concomitant social unrest and exacerbated racial tensions, it remains unknown if or how these factors could impact external validity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    The high level of education and disciplinary-specific knowledge in the sample of counselor educators in Study 1 may not reflect the views of the client participants in Study 2 or be generalizable to clients broadly.

    “The high level of education and disciplinary-specific knowledge in the sample of counselor educators in Study 1 may not reflect the views of the client participants in Study 2 or be generalizable to clients broadly.”
    Quote in the paperNot a substantial claim
48 of 48

  • The authors state this as an assumption.

    Each participant has a unique lens in perceiving and understanding culturally relevant frameworks.

    “Grounded in the constructivism-interpretivism paradigm, we recognize that each participant has a unique lens in perceiving and understanding culturally relevant frameworks, thereby leading to the richness and complexity within their perspectives.”

  • The paper relies on this without support.

    The two participant pools (counselor educators and clients) are sufficient to ensure generalizability across research-practice contexts.

    “We intentionally sought input from two distinct pools of participants (i.e., experts on multicultural counseling literature and clients who received mental health services) across the two studies to ensure that our findings had generalizability across research-practice contexts.”
2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reported SRMR values disagree with Table 4

    Minor

    The results text gives SRMRs of 0.29, 0.31, and 0.32 and says they are below the fit threshold, whereas Table 4 gives 0.029, 0.031, and 0.032. The values in the results text also exceed the stated 0.08 threshold.

  • Effect-size estimate lies outside its reported confidence interval

    Minor

    The reported effect-size estimate of 1.53 is outside its stated interval of [1.15, 0.199]. The interval's endpoints are also in descending order.

  • The stated first appearance of cultural humility conflicts with a 1998 citation

    Minor

    The paper says the term first appeared in 2013, but its cited 1998 publication has "Cultural humility" in its title.

  • The seven-item revision is called the original instrument

    Minor

    The measurement discussion calls CCCI-R7 the original instrument, but the measures section identifies it as a revision of an original 20-item instrument.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. American Counseling Association, 2014, ACA code of ethics
  2. Hays D. G., 2023, Qualitative research in education and social sciences
  3. Kozak K. T. Peters H. C. Luke M. &Dotger B.(In Revision).Thanks for coming in Ms. Wilson: A grounded theory of school counselor professional identity development.Journal of Counselor Leadership & Advocacy.
  4. 10.1007/s11606017‐4246‐0 · DOI
  5. 10.1037/cou0000086ss · DOI

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Authors
Zhu, P., Luke, M. M., Liu, Y., & Wang, Q.
Affiliations
  • Northern Illinois University (US)
  • Syracuse University (US)
Corresponding author
Zhu, Peitao
ORCID
Venue
Journal of Counseling & Development
Publisher
Wiley
Published
2023-04-25
Volume
101
Issue
3
Pages
264-276
ISSN
  • 0748-9633 (ISSN-L)
  • 1556-6676
DOI
10.1002/jcad.12469
OpenAlex
W4367053387
Semantic Scholar
b4e51eb5688b9b895c9d6ecb8579526428ef40e6
Cited by
34
References
45
Citations by year
2026: 15 · 2025: 11 · 2024: 7 · 2023: 1
FWCI
7.74
Type
journal article
Language
en
Open access
Licence
Locations
Journal of Counseling & Development (publishedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Cultural Competency in Health Care
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Keywords
cultural humility, cultural competence, multicultural counseling, counselor educators, counselor characteristics, counselor behavior, mental health services, counseling process

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-11-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-11-08.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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