Are You Culturally Competent?

Are you culturally competent?

Multicultural awareness – which refers to an awareness of, comfort with, and sensitivity toward issues of cultural diversity – has been emphasized through decades of policy reforms, is often taught in health care professions, and from all perspectives, is becoming more important every day.

What we believe about other cultures has a tremendous impact on how effective we are when working with them. One study found that multicultural beliefs are tied to student teachers’ ability to create strong and nurturing classroom environments, measured during student teaching observations by master teachers (Cherng & Davis, 2017).

Interestingly, this same study also found that Black and Latino preservice teachers report greater multicultural awareness than their White counterparts, and that prior experience working with minority cultures is linked to greater multicultural awareness (Cherng & Davis, 2017).

Being aware of cultural differences also becomes crucial when working with families after a suicide. According to Karen Rizzo MD, president of the Pennsylvania Medical Society (PAMED), suicide “is an alarming public health problem that needs to be addressed in a clinically compassionate way being culturally sensitive to the needs of those seeking to find answers to their personal loss” (Rizzo, 2012).

As Rizzo notes, the warning signs of suicide typically involve factors like previous suicide attempts, feeling alone, drug use, a family history of suicide, a history of depression, stressful life events and access to lethal methods, but can very according to an individual’s culture (Rizzo, 2012).

How much a person identifies with their culture can also influence their sense of belonging, well-being, and according to work done by Led by Kamaldeep Bhui, Professor of Cultural Psychiatry and Epidemiology at Barts, predicts their mental health later in life (Bhui et al., 2016).

Working effectively with people from different cultures means not just understanding the cultural norms, expectations, and pressures of an individual’s culture, but also how the individual experiences them. They may be highly identified with their culture and finding a sense of belonging in it, they may be resisting their culture in favor of integrating more fully into the majority culture, and they may not know how they feel about their culture, or the majority culture in which they live. All of these factors demand a culturally competent and sensitive approach – one that overcomes biases, stigmas, and includes the client in the process of improving mental health.

By Claire Dorotik-Nana, LMFT

Related Online Continuing Education (CE) Courses:

Cultural Awareness in Clinical PracticeCultural Awareness in Clinical Practice is a 3-hour online continuing education (CE/CEU) course that provides the foundation for achieving cultural competence and diversity in healthcare settings. Cultural competence, responding to diversity and inclusion, are important practices for healthcare professionals. This course will help you to gain an awareness of bias and provide strategies to adjust your clinical mindset and therapeutic approach to adapt to “the other” – people who differ in color, creed, sexual identification, socio-economic status, or other differences that make inclusion difficult. Inclusion is defined as “the state of being included” or “the act of including,” which is something all clinicians should strive for. This course is designed to provoke thought about culture, diversity, and inclusion. Even though research for evidence-based practice is somewhat limited in this area, the concept of cultural competency (however it is defined and measured) is a key skill for healthcare professionals to create an inclusive therapeutic environment. Course #31-07 | 2018 | 57 pages | 20 posttest questions

Suicide PreventionSuicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions

These online CE courses are sponsored by:

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

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Cultural Formulation Interview


cultural competence in healthcarePsychiatric and mental health in America has not succeeded at engaging people diagnosed with mental illness in their own care and empowering them and their families to become true partners with their providers. Misunderstandings and miscommunications can lead to dissatisfaction with treatment and sometimes even discontinuation. But when the whole of a person is taken into account, not only is the person likely to stay in treatment, they are likely to have a greater chance of recovery.

The APA is offering the Cultural Formulation Interview (CFI), including the Informant Version, and the Supplementary Modules to the Core Cultural Formulation Interview for further research and clinical evaluation. They should be used in research and clinical settings as potentially useful tools to enhance clinical understanding and decision-making and not as the sole basis for making a clinical diagnosis. Additional information can be found in DSM-5 in the Section III chapter “Cultural Formulation.” The APA requests that clinicians and researchers provide further data on the usefulness of these cultural formulation interviews at

Online assessment measures, including the CFI, are available @

The Cultural Formulation Interview (CFI) is a set of 16 questions that clinicians may use to obtain information during a mental health assessment about the impact of culture on key aspects of an individual’s clinical presentation and care.

The goal of the CFI is to lay the foundation for person-centered care and shared decision-making by encouraging clinicians to engage people seeking services and their families, from the very start, in a dialogue about how their cultural identities, values and prior experiences shape their care expectations and goals. But the CFI remains an underdeveloped tool. Clinicians and people living with mental illness need to know that it exists, and to use it to build a new type of partnership, without prejudice or stereotypes. All people diagnosed with mental illness have cultural identities, and our mental health system cannot expect any one of them to leave who they are at the door.