The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.
Cultural humility: Measuring openness to culturally diverse clients.
Abstract
Building on recent theory stressing multicultural orientation, as well as the development of virtues and dispositions associated with multicultural values, we introduce the construct of cultural humility, defined as having an interpersonal stance that is other-oriented rather than self-focused, characterized by respect and lack of superiority toward an individual's cultural background and experience. In 4 studies, we provide evidence for the estimated reliability and construct validity of a client-rated measure of a therapist's cultural humility, and we demonstrate that client perceptions of their therapist's cultural humility are positively associated with developing a strong working alliance. Furthermore, client perceptions of their therapist's cultural humility were positively associated with improvement in therapy, and this relationship was mediated by a strong working alliance. We consider implications for research, practice, and training.
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The CHES was found to have a strong correlation (r = .84, p < 0.01) with the CHS, demonstrating convergent validity.
“The CHES was found to have a strong (r = 84, p < 0.01) with the CHS (Hook et al., 2013), demonstrating convergent validity.”
From Cultural humility and cultural competence in counseling: An exploratory mixed methods investigation (2023) · cites this paper as Hook et al., 2013
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).”
From Cultural humility and cultural competence in counseling: An exploratory mixed methods investigation (2023) · cites this paper as Hook et al. (2013)
Hook et al. (2013) found that clients' perception of counselors' CC is moderately correlated (r = 0.64, p < 0.001) with their CH.
“Hook et al.'s (2013) found that clients' perception of counselors' CC is moderately correlated (r = 0.64, p < 0.001) with their CH;”
From Cultural humility and cultural competence in counseling: An exploratory mixed methods investigation (2023) · cites this paper as Hook et al., 2013
Hook et al. (2013) found that CH explained a modest (7%), but significant, amount of variance in therapeutic working alliance, above and beyond client's perception of their therapist's CC.
“further, through hierarchical regression analyses, the authors found that CH explained a modest (7%), but significant, amount of variances in therapeutic working alliance, above and beyond client's perception of their therapist's CC.”
From Cultural humility and cultural competence in counseling: An exploratory mixed methods investigation (2023) · cites this paper as Hook et al., 2013
Citations
Cites
Preacher, K. J., & Hayes, A. F. (2008) · Behavior Research Methods · doi:10.3758/brm.40.3.879 · Cited by 34,117
Alliance in individual psychotherapy
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011) · Psychotherapy · doi:10.1037/a0022186 · Cited by 2,072
Factor structure of the working alliance inventory
Tracey, T. J., & Kokotovic, A. M. (1989) · Psychological Assessment: A Journal of Consulting and Clinical Psychology · doi:10.1037/1040-3590.1.3.207 · Cited by 1,501 · cited 5×
“The WAI-SF consists of 12 items that measure three aspects of a strong working alliance with the therapist: task (e.g., “What I was doing in counseling gave me new ways of looking at my problem”), goal (e.g., “My counselor and I were working towards mutually agreed upon goals”), and bond (e.g., “My counselor and I tru…”
BackgroundMethodInfluentialWho knows what about a person? The self–other knowledge asymmetry (SOKA) model.
Vazire, S. (2010) · Journal of Personality and Social Psychology · doi:10.1037/a0017908 · Cited by 1,080
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Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S.-J., & Reid, P. (2019) · International Journal for Equity in Health · doi:10.1186/s12939-019-1082-3 · Cited by 1,214
The multicultural orientation framework: A narrative review.
Davis, D. E., DeBlaere, C., Owen, J., Hook, J. N., Rivera, D. P., Choe, E., Van Tongeren, D. R., Worthington, E. L., & Placeres, V. (2018) · Psychotherapy · doi:10.1037/pst0000160 · Cited by 256
Self-citationMyers, K., Nelson, E.-L., Rabinowitz, T., Hilty, D., Baker, D., Barnwell, S. S., Boyce, G., Bufka, L. F., Cain, S., Chui, L., et al. (2017) · Telemedicine and e-Health · doi:10.1089/tmj.2017.0177 · Cited by 192
Treatment adherence: The importance of therapist flexibility in relation to therapy outcomes.
Owen, J., & Hilsenroth, M. J. (2014) · Journal of Counseling Psychology · doi:10.1037/a0035753 · Cited by 177
Self-citationIntellectual humility and religious tolerance
Hook, J. N., Farrell, J. E., Johnson, K. A., Van Tongeren, D. R., Davis, D. E., & Aten, J. D. (2017) · The Journal of Positive Psychology · doi:10.1080/17439760.2016.1167937 · Cited by 136
Self-citationImplementing Mindfulness in the Mainstream: Making the Path by Walking It
Crane, R. S. (2017) · Mindfulness · doi:10.1007/s12671-016-0632-7 · Cited by 81
Intellectual Humility and Forgiveness of Religious Conflict
Zhang, H., Farrell, J. E., Hook, J. N., Davis, D. E., Van Tongeren, D. R., & Johnson, K. A. (2015) · Journal of Psychology and Theology · doi:10.1177/009164711504300403 · Cited by 46
Self-citationPalitsky, R., & Kaplan, D. M. (2021) · Mindfulness · doi:10.1007/s12671-019-01253-0 · Cited by 46
Humility in novice leaders: links to servant leadership and followers’ satisfaction with leadership
Krumrei-Mancuso, E. J., & Rowatt, W. C. (2023) · The Journal of Positive Psychology · doi:10.1080/17439760.2021.1952647 · Cited by 36
Cultural humility and cultural competence in counseling: An exploratory mixed methods investigation
Zhu, P., Luke, M. M., Liu, Y., & Wang, Q. (2023) · Journal of Counseling & Development · doi:10.1002/jcad.12469 · Cited by 34
Vesely, C. K., Brown, E. L., & Mehta, S. (2017) · Journal of Early Childhood Teacher Education · doi:10.1080/10901027.2017.1345805 · Cited by 32
Meagher, B. R., Gunn, H., Sheff, N., & Van Tongeren, D. R. (2019) · Journal of Psychology and Theology · doi:10.1177/0091647119837010 · Cited by 22
Cultural Adaptations of Acceptance and Commitment Therapy
Masuda, A., Morgan, L., Spencer, S. D., Qinaʻau, J., & Jo, D. (2022) · The Oxford Handbook of Acceptance and Commitment Therapy · doi:10.1093/oxfordhb/9780197550076.013.30 · Cited by 12
Zentner, K. E., Dueck, B. S., Le, J., & Lee, H. (2025) · Journal of Mental Health Counseling · doi:10.17744/mehc.47.3.02
O'Brien, C., & Charura, D. (2026) · MultiPsych · doi:10.1002/mps2.70012
Metadata
- Authors
- Hook, J. N., Davis, D. E., Owen, J., Worthington, E. L., & Utsey, S. O.
- Affiliations
- University of North Texas (US)
- Georgia State University (US)
- University of Louisville (US)
- Virginia Commonwealth University (US)
- Venue
- Journal of Counseling Psychology
- Published
- 2013-07
- Volume
- 60
- Issue
- 3
- Pages
- 353-366
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- OpenAlex
- W2070982161
- Cited by
- 1,317
- References
- 4
- Citations by year
- 2026: 174 · 2025: 153 · 2024: 120 · 2023: 135 · 2022: 126 · 2021: 122 · 2020: 142 · 2019: 118 · 2018: 85 · 2017: 53 · 2016: 54 · 2015: 22 · 2014: 11 · 2013: 1
- FWCI
- 29.39
- Type
- journal article
- Language
- en
- Update notices
- correction (2015-01-19)
- Open access
- closed
- Locations
- Journal of Counseling Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- John Templeton Foundation
- Sponsor name not included (14979)
- University of North Texas
- Topics
- Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Keywords
- cultural humility, multicultural orientation, multicultural values, therapeutic relationship, client perceptions of therapists, treatment outcomes, cultural diversity, therapist training
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Professional-Patient Relations, Students, Patient Satisfaction, Cultural Competency, Young Adult
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