Moving Beyond Mere Cultural Competence in Counseling: What to Know
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“Cultural competence has been the baseline benchmark, the bare minimum standard to ethically practice with clients. We’re now moving to frameworks such as cultural humility, intersectionality, and decolonizing mental health to ensure we reach all the people who have mental health needs in ways that align with their cultural identities and reduce the impact oppression has on them.”
Dr. Candice Hargons, Licensed Clinical Psychologist & Associate Professor of Counseling Psychology, University of Kentucky
At the heart of the counseling profession lies a commitment to ethics. In fact, the American Counseling Association’s code of ethics describes its five core professional values as the “way of living out an ethical commitment.”
Two of these values include: 1) honoring diversity and embracing a multicultural approach, and 2) promoting social justice.
The ACA’s code of ethics also calls on counselor educators to “actively infuse multicultural/diversity competency in their training and supervision practices” and to “actively train students to gain awareness, knowledge, and skills in the competencies of multicultural practice.”
However, what used to be touted as the skill for engaging in cross-cultural work, cultural competence, is now recognized as “the baseline benchmark” according to Dr. Candice Hargons, associate professor of psychology at the University of Kentucky.
In order to work in a truly ethical manner within the profession, counselors are being called upon to go beyond what she considers the bare minimum in counseling practice.
What does this mean for counseling professionals in 2021? In the following interview, psychology professor Dr. Hargons generously offered her expertise on what constitutes ethical counseling practice today.
Meet the Expert: Candice Hargons, PhD
Dr. Candice Hargons is an associate professor of counseling psychology at the University of Kentucky and a licensed clinical psychologist. Her academic work entails the study of sex, social justice, and leadership, while her clinical practice focuses on healing racial trauma and sex therapy.
As the director of the RISE^2 Research Team and the Center for Healing Racial Trauma, Dr. Hargons approaches all of her work with a love ethic, defined by bell hooks as “the right for everyone to live fully and well.”
Dr. Hargons’ most recent scholarly work, addressing how Black students at a predominantly white college in the southeast define racial trauma, was published in Cultural Diversity and Ethnic Minority Psychology in 2021. Her numerous honors and awards include the Outstanding Contribution to Scholarship on Race and Ethnicity Award (2018) from the Society of Counseling Psychology Section on Ethnic & Racial Diversity.
When asked what is important for aspiring counselors to know about cultural competence, Dr. Hargons shared that,
Cultural competence has been the baseline benchmark, the bare minimum standard to ethically practice with clients. We’re now moving to frameworks such as cultural humility, intersectionality, and decolonizing mental health to ensure we reach all the people who have mental health needs in ways that align with their cultural identities and reduce the impact oppression has on them.
The fact that community members with marginalized identities have historically sought counseling services less than others and face more barriers when they do, attests to the necessity of going beyond the baseline benchmark of cultural competence. Dr. Hargons continued, “This is important because many people with marginalized identities are just now being open to therapy, so we want to provide the best experience for them.”
Let’s examine these concepts and how they can be used to cultivate an ethical counseling practice.
Cultural Competence vs. Cultural Humility
Cultural competence was introduced in the 1980s by social workers and counseling psychologists as an approach to working successfully in multicultural contexts. Primarily concerned with learning about the cultures of those with whom we live and work through the examination of behaviors, attitudes, and policies, cultural competence was embraced by the healthcare community and has been used widely throughout the industry.
While both concepts deal with cultural learning, there are differences that have raised concerns. Cultural competence has been found inadequate for implying that there is an “end” to cultural learning as well as concerns regarding its “top-down” approach and potential to lead to stereotyping.
Cultural humility, on the other hand, explicitly deals with cultural learning as a life-long endeavor and includes the exploration of one’s own identity within the social construct. Introduced by Melanie Tervalon and Jane Murray-Garcia in 1998, they defined the term as:
A lifelong commitment to self-evaluation and critique, to redressing power imbalances…and to developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individuals and defined populations.
In Cultural Competence or Cultural Humility: Moving Beyond the Debate, Ella Greene-Moton and Meredith Minkler argue for a “both/and” approach rather than “either/or.” Their argument lies in that these are complementary concepts, that cultural competence couched within cultural humility is a way to leverage both for the benefit of health equity. Perhaps for some, this can be a starting point.
Law professor and critical race theory scholar Dr. Kimberlé Crenshaw introduced the concept of intersectionality 28 years ago. In an interview with Columbia School of Law, where she serves on the faculty, she explained, “Intersectionality is a lens through which you can see where power comes and collides, where it interlocks and intersects.”
The link to cultural humility becomes clear. In order to redress power imbalances, we need to understand how things got this way. Intersectionality provides a framework for doing so.
Dr. Crenshaw warns, however, that the term can be used dismissively to explain complicated interactions of power and, thus, lead to complacency. One way she and her colleagues at the African American Policy Forum and the Center for Intersectionality and Policy Studies counteract this is through public education. They illustrate lived experiences of intersectional harm through art and other project-based means of expression.
Decolonizing Mental Health
Cultural humility and intersectionality lay the groundwork for exploring the decolonization of mental health. In an interview with The Cnnekt, clinical psychologist Dr. Jennifer Mullen explained that:
To decolonize therapy is to reconnect to the humanization of therapy, to reclaim therapy, to include systems and oppression into our therapy practices and analysis, and to re-humanize therapists (bring them down from some pedestals), as well as to center the person and their cultural and political identities back into the Work.
She further describes the decolonization of mental health as remembering and transforming, as healing and dismantling, and that to do so is “to remember and connect our current struggles, practices, and beliefs to that of our People.”
This requires the practice of witnessing. The decolonization of therapy, Dr. Mullan shared, begins with the decolonization of the Self. So, be a witness to your Self. Explore the ways you’ve been a part of oppressive cultures and systems. Perhaps you’ve benefitted in some ways and have been exploited in others. Do your own work first, and use what you learn to serve as a witness to others.
From Theory to Practice: The Love Ethic & Liberation Psychology
On the landing page of her website, Dr. Hargons writes that she’s a teacher, healer, scholar, and leader who operates in a love ethic. What does this mean? She described,
I draw from bell hooks’ work, where she defines a love ethic as the right for everyone to live fully and well. She says, “Embracing love ethic means that we utilize all dimensions of love—care, commitment, trust, responsibility, respect and knowledge—in our everyday lives.”
It is these dimensions that guide Dr. Hargons’ research, practice, and outreach. She does this by establishing respect and trust: “I allow others to define what living fully means for them and then engage with them from that understanding,” she explained. “It also means I choose to study topics that affirm wellness, rather than continue to advance a medical model. So, I study sex positivity and healing racial trauma.”
In her work with individuals healing from racial and ethnic trauma, Dr. Hargons uses a mind/body approach rooted in liberation psychology. Originating from emancipatory movements in Latin America, the American Psychological Association states that:
Liberation practitioners work in a collaborative and participatory manner with oppressed people and populations. They place individuals in multiple contexts, including cultural, historical, gender, sexual orientation, sociopolitical, geopolitical, and other intersecting factors. In this way, liberation psychologists recognize the impact of the confluence of context, history, social location, and power–powerlessness on health and well-being.
Dr. Hargons explains how this informs her work:
I incorporate a combination of mind/body techniques from a liberation perspective by acknowledging that racism is not just a psychological experience. It is an embodied/somatic experience, and it is also a systemic/relational experience. So, the way I engage therapeutically has to attend to the myriad ways people suffer the consequences of racism.
An example of this approach is the “Black Lives Matter Meditation for Healing Racial Trauma” Dr. Hargons’ developed to help Black people who are experiencing racism. She did so because she “wanted to provide a freely available resource that worked for the mind and body.”
She also developed “The Ally + Accomplice Meditation for Cultivating an Anti-Racist Mindset” for white people who identify as allies and/or accomplices to Black people. These resources are available on Dr. Hargons’ website and on the Center for Healing Racial Trauma’s resource page.
At the heart of her work is a commitment to providing ethical mental healthcare backed by sound research. This is the approach used at the Center for Healing Racial Trauma, where Dr. Hargons serves as executive director. They use research to develop evidence-based interventions as well as to further refine how they intervene “to give people of the global majority (racially/ethnically marginalized people) the best possible therapeutic experience.”
Where to Begin: Developing Cultural Humility & Authentic Relationships
For counseling students serving BIPOC, LGBTQIA+, veterans, and other marginalized communities with which they may not have experience, Dr. Hargons recommends starting with education. Learn about the cultures of your future clients from members of their communities using the framework of cultural humility as a guide. She explained,
Be willing to engage their cultures through the media they create for themselves (books, social media, movies, magazines, and peer-reviewed research). Learn from the content people in marginalized communities have already contributed, and be a humble, life-long learner in this.
Dr. Hargons also discussed the importance of developing relationships. One way to do this as part of the counseling community is through professional membership in an ethnic minority psychological association (EMPA). She explained:
Be in an authentic relationship with people in those communities. If you haven’t already established those relationships, start now. Join EMPAs, connect in mutually respectful and beneficial ways, and trust the leadership of marginalized people who already know what they need for their wellness. Then, you can be in solidarity with them, rather than assuming you’re coming to save them.
Finally, cultivate your self-awareness in a way that produces action. Get to know how you benefit from the systems that may oppress others and challenge yourself (without self-shaming or guilt) to be accountable in communities that take liberation for everyone seriously.
Resources for Counseling Professionals on Decolonizing Mental Health & Social Justice
The witnessing of the Self that the decolonization of mental health requires must be paired with action to create lasting change. To address the barriers to mental health services that community members with marginalized identities are more likely to face, social justice engagement is crucial.
On the role this plays in the work of a counseling professional, Dr. Hargons shared,
Social justice is about reducing the external, systemic factors that impact mental health. The disparities in our education systems, workforce, healthcare systems, and political systems influence mental health outcomes.
For example, if someone is raised in a neighborhood that has been experiencing political neglect and low funding, they are more likely to be exposed to traumatic experiences and stressors that can have mental health consequences. Social justice is about going beyond individual intervention to advocate for systemic change.
To learn more about going beyond cultural competence in your work as a counseling professional and become an advocate for social justice, check out the following resources:
- White People Stress Me Out All The Time: How Black Students Define Racial Trauma – Dr. Candice Hardons’ most recent publication explores racial trauma from the perspective of Black students at a predominantly White university in the southeastern United States.
- Center for Healing Racial Trauma: BLM & Allies Meditations – The resource page of the Center for Healing Racial Trauma features the BLM and Allies Meditations described above. Also available on executive director Dr. Candice Hargons’ website.
- Ethnic Minority Psychological Associations – This page is hosted on the American Psychological Association’s website and includes links to EMPAs, EMPA newsletters, and editor contact information.
- Cultural Humility: People, Principles, and Practices – Take a deeper look at cultural humility in this documentary by Dr. Vivian Chavez, professor of health education at San Francisco State University.
- The Urgency of Intersectionality with Kimberlé Crenshaw – Learn more about intersectionality and its necessity in our times from the person who coined the term 20 years ago, Dr. Kimberlé Crenshaw of Columbia and UCLA Law.
- PBS Series: Decolonizing Mental Health – In this video series, hear the stories of individuals with marginalized identities as they share their experiences with mental health challenges and services.
- Decolonizing Therapy Resources from Jennifer Mullan – Find resources for decolonized mental health services in this list compiled by Dr. Jennifer Mullan, a psychologist at New Jersey City University.