Cultural Humility in Therapy: Creating Healing Spaces for All
By Elle Murphy, MSW, LSW
The goal of cultural humility is creating spaces where every person feels truly seen, understood, and valued for who they are—whole human beings with complex identities, and unique ways of understanding the world around them.
Why Cultural Humility Matters in Perinatal Mental Health
Mothers from marginalized communities experience significantly higher rates of perinatal depression and anxiety. For instance, Black and Latina mothers experience postpartum depression at rates of 38% compared to 21% of all mothers, with a staggering 60% receiving no treatment at all (Gress-Smith et al., 2012; Wisner et al., 2013).
These statistics represent real mothers struggling in silence, carrying the weight of cultural expectations while navigating systems that often are not yet designed with their experiences in mind. Each number represents a family affected, children who may not receive the emotionally available parent they deserve, and communities losing valuable voices to preventable suffering.
The disparities extend beyond access to care. When mothers from marginalized communities do seek help, there is a risk of encountering providers who lack cultural competence, facing discrimination within healthcare systems, or receive treatment that doesn't align with their values and worldview. This creates a cycle where the systems meant to heal can inadvertently cause additional harm through cultural invalidation or misunderstanding.
What Cultural Humility Looks Like in Practice
Cultural humility means recognizing that one can never fully "know" another person's culture, no matter how much training or education they receive. It involves approaching each client with genuine curiosity, respect, and the fundamental understanding that they are the expert of their own experience. This approach requires therapists to step away from the role of cultural interpreter and instead become cultural students, learning from each client about their unique traditions, values, and experiences.
Cultural humility emphasizes the ongoing process of self-reflection, recognizing power dynamics, and maintaining a learner's mindset. It acknowledges that culture is not monolithic—that two people from the same ethnic background may have vastly different cultural experiences based on factors like socioeconomic status, generation, geography, religion, and personal history.
This approach recognizes that culture encompasses socioeconomic background, religious beliefs, sexual orientation, gender identity, disability status, educational background, and countless other factors that shape how someone moves through the world. A truly humble approach considers all these intersecting identities and how they might influence someone's therapeutic needs and goals.
It's About Self-Reflection First
Before one can effectively serve clients from diverse backgrounds, they must continuously examine their own cultural lens and the unconscious biases that inevitably shape their worldview. This introspective work is foundational to culturally humble practice. It is essential to ask yourself challenging questions on a regular basis:
What assumptions am I making based on someone's appearance, name, accent, or background?
How do my own cultural experiences and privileges shape how I understand and interpret their story?
What biases might I hold about different approaches to family structures, mental health, help-seeking, or child-rearing?
How does my training in Western therapeutic models influence what I consider "healthy" or "normal"?
What stereotypes have I internalized about certain communities, and how might these impact my ability to see clients clearly?
How do my own experiences with privilege or marginalization affect my understanding of systemic barriers?
This self-examination isn't a one-time exercise completed, it's ongoing and it means being willing to sit with the discomfort of recognizing your own limitations and blind spots. It means actively seeking out education, consultation, and supervision to address these gaps. Most importantly, it means understanding that this work is never finished; as society evolves and our understanding deepens, so too must our self-awareness.
The process of self-reflection also involves examining the power dynamics inherent in therapeutic relationships. Therapists must acknowledge how their professional status, and educational background may create barriers to authentic connection. This awareness allows for more intentional efforts to level the playing field and create genuinely collaborative therapeutic relationships.
It's About Asking, Not Assuming
Rather than making assumptions based on someone's ethnicity, appearance, or background, culturally humble practice centers on asking open-ended questions that invite clients to share their unique perspectives. This approach demonstrates respect for their expertise while avoiding the harmful practice of applying generalized cultural knowledge to individual experiences.
Essential questions that open doors to deeper understanding include:
"Can you help me understand what mental health means in your family or cultural background?"
"What does being a 'good mother' look like within your cultural context, and how do you feel about those expectations?"
"What cultural strengths or traditions do you draw from during difficult times?"
"How would you like your family or community involved in your healing process?"
"Are there cultural or spiritual practices that are important to your well-being?"
"How do you typically cope with stress or emotional difficulties?"
"What would healing look like for you, in your own words?"
"How do you prefer to communicate difficult emotions or experiences?"
Throughout the therapeutic process, culturally humble practitioners continue to check in, ask for clarification, and invite clients to educate them about aspects of their experience that might not be immediately apparent. This ongoing curiosity prevents assumptions from creeping in and maintains the collaborative nature of the therapeutic relationship.
The Ongoing Journey of Cultural Humility
Systemic Change and Advocacy often become natural extensions of culturally humble clinical practice. As therapists develop deeper understanding of the systemic barriers their clients face, many feel called to advocate for policy changes, organizational improvements, or community-level interventions that address root causes of mental health disparities.
This might involve advocating for more diverse hiring in healthcare settings, pushing for culturally responsive training requirements, supporting community-based mental health initiatives, or working to address social determinants of health that impact mental wellness. The goal is not to abandon individual therapy but to complement it with efforts that address systemic inequities.
Cultural humility in perinatal mental health is more than a therapeutic approach, it’s a commitment to justice, healing, and the recognition that every person deserves to be seen, understood, and valued for who they truly are. When we approach our work with genuine humility, curiosity, and respect for the wisdom that each client brings, we create the conditions for profound healing and transformation that honors the full richness of human diversity.
Every client teaches us something new about resilience, strength, and the beautiful complexity of human experience. This ongoing learning creates not only better therapists but also more compassionate human beings, better equipped to serve all the parents who trust us with their stories and their healing journeys.
Gress-Smith, J. L., Luecken, L. J., Lemery-Chalfant, K., & Howe, R. (2012). Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Maternal and Child Health Journal, 16, 887–893. https://doi.org/10.1007/s10995-011-0812-y
