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The Case for Cultural Competency in Psychotherapeutic Interventions
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Cultural competency practices have been widely adopted in the mental health field because of the disparities in the quality of services delivered to ethnic minority groups. In this review, we examine the meaning of cultural competency, positions that have been taken in favor of and against it, and the guidelines for its practice in the mental health field. Empirical research that tests the benefits of cultural competency is discussed.
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“When compared to White Americans, racial/ethnic minority populations have less access to mental health care, are less likely to receive care, and when they do, it tends to be poorer in quality (Institute of Medicine, 2001; Sue, Zane, Nagayama Hall, & Berger, 2009; U.S. Department of Health and Human Services [DHHS], 2001).”
From Guest Editors' Introduction to the Special Section: Cultural Adaptation of Mental Health Interventions for Americans of East Asian Descent (2019) · cites this paper as Sue, Zane, Nagayama Hall, & Berger, 2009
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“Importantly, the cross-cultural validity of these processes is actively debated.”
From Differential associations of Acceptance and Commitment Therapy processes with psychological distress across racial groups. (2026) · cites this paper as [19]
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“Sue et al. (2008) emphasize the need for practitioners to be aware of their own cultural beliefs and values, have knowledge of the client’s culture, and possess the skills to intervene in clinically meaningful and appropriate ways.”
Asian American mental health: a call to action
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“…competencies (e.g., discerning the worldviews of clients) should lead to greater clinician credibility, which in turn should contribute to client improvement (Sue & Zane 1987, Sue et al. 2009, Wade & Bernstein 1991), yet we know of no studies that have tested this mediating causal sequence.”
BackgroundInfluentialCultural competence in healthcare in the community: A concept analysis
Henderson, S., Horne, M., Hills, R., & Kendall, E. A. (2018) · Health & Social Care in the Community · doi:10.1111/hsc.12556 · Cited by 238
“…the provision of individualised quality care (Allen et al., 2013; Carpenter & Garcia, 2012; Carpenter- Song et al., 2007; Garneau & Pepin, 2015; Garran & Werkmeister Razas, 2013; Harmsen et al., 2005; Harper, 2006; Kleiman, 2006; Majumdar et al., 2004; Sue et al., 2008; Tayab & Narushima, 2015).”
Advancement in the maturing science of cultural adaptations of evidence-based interventions.
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THE INFLUENCE OF RACE AND ETHNICITY IN CLIENTS’ EXPERIENCES OF MENTAL HEALTH TREATMENT
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“However, the majority of impacted youth do not receive eating disorder treatment (Swanson et al., 2011), in part due to limited access to evidence-based treatments with qualified providers (Kazdin, Fitzsimmons-Craft, & Wilfley, 2017).”
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Self-citationA model for the theoretical basis of cultural competency to guide psychotherapy.
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Toward defining, measuring, and evaluating LGBT cultural competence for psychologists.
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“For the purposes of the current paper, the three-domain model of multicultural competence – one of the most commonly recognized frameworks – is used wherein cultural competence involves: (a) awareness of one's own beliefs, biases, and attitudes; (b) knowledge and understanding of the cultural group including expectati…”
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“Work with Latinos specifically finds the provision of daycare, culturally appropriate interventions, and the use of community health advisors or promotoras (to recruit clients and deliver interventions) helpful in the engagement and maintenance of clients in treatment (Elder et al. 2009; Organista and Muñoz 1996; Sue…”
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“Moreover, the application of these competencies in the realm of specific ethnoracial minority groups may help to draw attention to mental health disparities among these groups—an important reason for the development of cultural competence in the first place (S. Sue et al., 2009).”
BackgroundInfluentialEffects of mental health interventions with Asian Americans: a review and meta-analysis
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“Evidence on the efficacy and effectiveness of culturally adapted interventions is mounting (Barrera et al. 2013; Bernal et al. 2009a; Sue et al. 2009), including interventions designed or adapted specifically for Latino youth and their families (e.g., Domenech Rodrı́guez et al. 2011; McCabe and Yeh…”
BackgroundInfluentialModel minority stereotype: influence on perceived mental health needs of Asian Americans
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“Adapting MI to diverse populations should coincide with principles set forth in the cultural competence literature [25].”
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“Lewis (2015) identified several coping strategies implemented by Black professionals and college students: some stressreducing, such as collective coping (leaning on one's support network), using ones’ voice as power and actively resisting Eurocentric standards (Brondolo, Gallo, & Myers, 2009; Cross Jr., 2012; Lewis,…”
BackgroundInfluentialRefugee youth: A review of mental health counselling issues and practices.
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The Effects of a Multilingual Telephone Quitline for Asian Smokers: A Randomized Controlled Trial
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“As mentioned earlier, one reason that most US states have not adopted an Asian language quitline is the lingering concern that telephone counseling might not be an effective mode of intervention for recent Asian immigrants because talk therapy is not part of the Asian culture (18,23).”
BackgroundRuglass, L. M., Hien, D. A., Hu, M., Campbell, A. N. C., Caldeira, N. A., Miele, G. M., & Chang, D. F. (2014) · Community Mental Health Journal · doi:10.1007/s10597-014-9732-9 · Cited by 58
“Researchers and clinicians in the field have called for the use of more culturally competent strategies in order to reduce disparities in treatment outcomes (e.g., Campbell and Alexander 2002; Ford 2008; Sue et al. 2009).”
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“Despite ample discussion of MC in intervention and prevention, we are unaware of any discussions further defining MC in terms of intervention competence, other than a broad acknowledgment that MC should govern intervention development, evaluation, and delivery (S. Sue et al., 2009).”
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Cultural Relevance of Physical Activity Intervention Research with Underrepresented Populations
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Towards a cultural-developmental psychology of music in adolescence
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“This is the case when interveners develop cultural awareness, knowledge, and skills; consider communication issues, cultural variations of symptoms, and acculturation; and collaborate with interpreters, culture brokers, family members, and community organizations (Kirmayer et al., 2011; Ryder et al., 2011; Sue et al.,…”
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“There are multiple arguments in favour of adapting CBT for people from a diverse background (Sue et al., 2009).”
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“Moreover, research suggests that clinical staff exhibit lower psychological resilience, especially if their hours are long, than administration staff (Sull et al ., 2015).”
BackgroundMulticultural Counseling Competence: A Construct in Search of Operationalization
Ridley, C. R., Mollen, D., Console, K., & Yin, C. (2021) · The Counseling Psychologist · doi:10.1177/0011000020988110 · Cited by 57
“Other phrases like multicultural self-efficacy, cross-cultural competence, cultural validity, and cultural humility add to the intermingling (Hook & Watkins, 2015; Robitschek & Hardin, 2017; S. Sue et al., 2009; Wei et al., 2012).”
BackgroundWork and Unemployment as Stressors
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The Process Model of Multicultural Counseling Competence
Ridley, C. R., Sahu, A., Console, K., Surya, S., Tran, V., Xie, S., & Yin, C. (2021) · The Counseling Psychologist · doi:10.1177/0011000021992339 · Cited by 54
“Although we acknowledge that the adaptation and process-oriented models emerged as counters to the one-size-fits-all assumption undergirding the skills-based model (Bernal et al., 2009; Sue et al., 2009), we nevertheless aim to intentionally integrate components of all three models rather than stand alone from them.”
BackgroundMethodGone, J. P. (2022) · American Journal of Community Psychology · doi:10.1002/ajcp.12591 · Cited by 44
Ethnoracial Variation in Women’s Exposure to Intimate Partner Violence
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U.S. mental health policy: Addressing the neglect of Asian Americans.
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How Staff of Youth Programs Respond to Culture-Related Incidents
Gutiérrez, V., Larson, R. W., Raffaelli, M., Fernandez, M., & Guzman, S. (2016) · Journal of Adolescent Research · doi:10.1177/0743558416664028 · Cited by 43
Chavez‐Korell, S., Benson-Flórez, G., Rendón, A. D., & Farías, R. (2013) · The Counseling Psychologist · doi:10.1177/0011000013477906 · Cited by 41
Magill, M., Martino, S., & Wampold, B. E. (2021) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2021.108442 · Cited by 50
Theoretical and Empirical Foundations for Ecotherapy
Doherty, T. J. (2016) · doi:10.1057/978-1-137-48688-2_2 · Cited by 40
Ethical issues in participatory arts methods for young people with adverse childhood experiences
Pavarini, G., Smith, L. M., Shaughnessy, N., Mankee‐Williams, A., Thirumalai, J. K., Russell, N., & Bhui, K. S. (2021) · Health Expectations · doi:10.1111/hex.13314 · Cited by 41
“with project participants, including for example, the use of preferred pronouns and identity first language.(48,49)”
A dyadic study of multicultural counseling competence.
Dillon, F. R., Odera, L. A., Fons-Scheyd, A. L., Sheu, H., Ebersole, R. C., & Spanierman, L. B. (2015) · Journal of Counseling Psychology · doi:10.1037/cou0000118 · Cited by 48
Seeking cultural competence from the ground up
Hayes, S. C., Muto, T., & Masuda, A. (2011) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2011.01254.x · Cited by 38
McBeath, B., Chuang, E., Bunger, A. C., & Blakeslee, J. E. (2014) · Social Service Review · doi:10.1086/675373 · Cited by 38
Cheremshynski, C., Lucyshyn, J. M., & Olson, D. L. (2012) · Journal of Positive Behavior Interventions · doi:10.1177/1098300712459904 · Cited by 38
A Handbook for the Study of Mental Health
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Horwitz, A. V. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.004 · Cited by 40
Metadata
- Authors
- Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K.
- Affiliations
- University of California, Davis (US)
- Department of Psychology, University of Oregon, Eugene, Oregon 97403;
- Venue
- Annual Review of Psychology
- Publisher
- Annual Reviews
- Published
- 2009-01-01
- Volume
- 60
- Issue
- 1
- Pages
- 525-548
- ISSN
- 0066-4308 (ISSN-L)
- 1545-2085
- PMC
- PMC2793275
- OpenAlex
- W2158121413
- Cited by
- 662
- References
- 117
- Citations by year
- 2026: 37 · 2025: 50 · 2024: 43 · 2023: 47 · 2022: 32 · 2021: 41 · 2020: 47 · 2019: 51 · 2018: 44 · 2017: 63 · 2016: 36 · 2015: 31 · 2014: 35 · 2013: 26 · 2012: 24
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annual Review of Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (P50MH073511)
- 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 competence, psychotherapy, ethnic minority mental health, mental health disparities
- MeSH terms
- Delivery of Health Care, Humans, Minority Groups, Prejudice, Psychotherapy, Quality Assurance, Health Care, Stereotyping, Cultural Competency, Healthcare Disparities
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