Cultural humility is a “self-first” approach to sociocultural differences; it involves learning about one’s own biases and thereby becoming more accepting of others.
It is a practice of self-reflection combined with an openness to understanding other cultures. It also involves acknowledging the power imbalances that exist in society. The concept of cultural humility was first developed in physical healthcare.
It was later adapted to various fields, such as social work, occupational therapy, etc. Cultural humility is quite different from cultural competence, as we will discuss later. But first, let us learn about the concept in more in detail and look at some examples.
Cultural Humility Definition
The National Institutes of Health (NIH) defines cultural humility as:
“…a lifelong process of self-reflection and self-critique whereby the individual not only learns about another’s culture, but one starts with an examination of her/his own beliefs and cultural identities.”
The concept was first developed by healthcare professionals Melanie Tervalon and Jann Murray-Garcia in 1998. Going against cultural competence—the prevailing sociocultural framework in healthcare at the time—they proposed a new way of addressing differences.
According to Tervalon & Murray-Garcia, cultural humility has three main aspects. First, a “lifelong commitment to self-evaluation and self-critique” (1998). Self-reflection allows us to understand our implicit biases and treat others with a greater degree of openness.
Secondly, it involves a desire to understand and address “power imbalances in the patient-physician dynamic”, and by extension, in the wider society. Finally, it encourages us to develop “mutually beneficial and non-paternalistic” partnerships with communities.
Cultural humility tells us to take our own lives as the starting point for understanding social differences. Once we understand the context of our life, we can begin to understand those of others by listening to their experiences.
It also implies a historical awareness. Only by learning about the historic realities (such as the legacies of oppression and violence) faced by different groups can we truly become sensitive to their present experiences.
Cultural Humility Examples
- Healthcare: The concept of cultural humility was first developed in the field of healthcare to provide more equitable treatment to all. A healthcare professional with cultural humility must listen to their patients with interest & curiosity while being willing to be taught by their patients. Tervalon (1998) gives the example of a nurse who felt that her cultural competency class had falsely allowed her to gain “expertise” in understanding people of Hispanic descent. This kind of stereotyping is precisely what cultural humility hopes to change.
- Social Work: After healthcare, the social work field began adopting cultural humility which serves as a strong self-reflection tool for workers. Cultural humility encourages social workers to learn about their own powers, privileges, and prejudices. It also makes them acknowledge that formal education and credentials alone are inadequate to address social inequality (Chavez, 2012). Cultural humility also teaches that clients (not service providers) are the authority when it comes to lived experiences. So, service providers must try to understand their worldviews (Moncho, 2013).
- Occupational Therapy: Cultural humility in occupational therapy allows a more effective approach to working with clients from diverse backgrounds. Occupational therapy promotes well-being by helping people pursue activities that are meaningful to them. Cultural humility in this field would mean respecting the clients’ integrity; learning about their lived experiences to determine best practices; building organizational support. The therapy would then become more effective, reduce culturally-based health disparities, and increase the global relevance of occupational therapy (Agner, 2020).
- Academia: In academia, cultural humility is a practice of self-reflection that helps to understand how one’s own background and the background of others impact teaching, learning, engagement, etc. (University of Oregon). A life-long commitment to self-reflection would allow academics to learn about their own biases, making them aware that they don’t have all the answers. It would also create a more inclusive environment for everyone. Finally, cultural humility involves understanding the systemic inequalities that impact academicians and advocating for policies that promote equity.
- Workplaces: Cultural humility at workplaces leads to a greater sense of belonging, improved collaboration, higher employee well-being, etc. Most marginalized social groups are heavily underrepresented in professional spaces. Cultural humility involves understanding that such imbalances exist and working towards rectifying them. Cultural humility is not a destination; instead, it is an orientation to the world & people around you (Cooks-Campbell, 2022). At workplaces, it can be promoted by investing in coaching, helping teams learn about each other, and letting others lead the conversation.
- Clinical Researchers: Cultural humility is necessary for clinical researchers, especially for those studying or working with someone different from themselves, whether in race, gender, religion, etc. The Tuskegee Syphilis Study is a tragic reminder of how African Americans (and most marginalized communities) have been abused and disrespected in clinical research. Such instances have led to mistrust between public health institutions and marginalized groups. Cultural humility can help address this mistrust by making clinical research more equitable and effective.
- Law enforcement: Cultural humility in law enforcement will lead to greater trust between police officers and communities. For police officers, cultural humility involves recognizing and challenging one’s personal biases. This can be done through training programs and ongoing engagement with community members. The murder of George Floyd is one of the many examples of racially-charged police violence, and cultural humility can mitigate such tragedies. It will lead to greater cultural sensitivity among the police officers, fostering trust between them and the people they serve.
- Schools: At the school level, cultural humility can help make students learn about themselves as well as others, making them more culturally sensitive. This can be implemented in numerous ways. Students can be encouraged to do personal reflection through journaling and engage in group discussions (including activities such as Think-Pair-Share). Teachers can also conduct immersive programs, such as role plays, site visits, event attendance, etc. Ultimately, these initiatives will help people learn about themselves from a young age while also learning about others.
- Media & Journalism: Historically, representations of marginalized communities in literature, art, and media have been severely biased; cultural humility can help change this. By promoting cultural humility, the media can move towards more accurate (and less stereotypical) representations. Moreover, there is a need for diverse perspectives. Cultural humility, by encouraging systemic changes, can lead to greater representation of marginalized voices, which would again lead to fairer depictions.
- Mental Health Care: In mental health care, cultural humility can help practitioners better understand and help their clients from diverse backgrounds. One excellent method of this is culturally adapted interventions, which means aligning treatments with the background of the client (Hwang, 2016). For example, while working with a Latino client, the therapist may include the client’s concepts of family & community, use Spanish-language materials for greater cultural relevance, etc.
Cultural Humility vs Cultural Competency
Cultural competency was the primary framework for dealing with sociocultural differences in the 1960s, but it had many limitations and was therefore replaced by cultural humility.
The concept of cultural competency arose in the backdrop of the Civil Rights movement during the 1960s and 70s. It meant the ability to engage with people from other cultures. It was a kind of “social fluency”—learning another culture and tailoring your communication/service accordingly. However, there were several problems with this framework.
First, it suggests that there is a certain categorical knowledge that one can obtain to “figure out” a group of people. As Cooks-Campbell writes so precisely, it’s like American businessmen taking “etiquette classes” before meeting foreign investors (2022).
It treats people of a certain social group as a monolith, caging them into stereotypes. Secondly, it takes the dominant culture as the “norm”, framing cultural incompetence as an inability to learn about the “other”. It doesn’t make us critically analyze our own selves.
Finally, it implies that there is an endpoint: follow these steps and will become culturally competent. In contrast, cultural humility is a lifelong commitment to self-reflection. It constantly tells us to look at our own lives, and then listen to others to learn from their experiences.
Cultural humility involves learning about one’s own biases and becoming more accepting of other cultures.
It is a lifelong commitment to self-reflection, which would allow us to constantly examine whether we are fair in our treatment of others or not. Unlike cultural competence, cultural humility is not an “achievable” set of skills. Instead, it is an orientation toward the world.
Agner, Joy (2020-06-09). “Moving From Cultural Competence to Cultural Humility in Occupational Therapy: A Paradigm Shift“. The American Journal of Occupational Therapy.
Cooks-Campbell, Allaya. (2022). “How cultural humility and cultural competence impact belonging”. BetterUp.
Chavez, Vivan. (2012). “Cultural Humility”. YouTube.
Hwang, W. C., Myers, H. F., Abe-Kim, J., & Ting, J. Y. (2016). “A conceptual paradigm for understanding culture’s impact on mental health: The cultural influences on mental health (CIMH) model”. Clinical Psychology Review.
Khan, Shamaila. (2021). “Cultural Humility vs. Cultural Competence — and Why Providers Need Both”. HealthCity/ https://healthcity.bmc.org/policy-and-industry/cultural-humility-vs-cultural-competence-providers-need-both
Moncho, Craig. (2013). “Cultural Humility, Part I – What is it?”. The Social Work Practitioner.
Tervalon, M.; Murray-García, J. (1998). Cultural Humility versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education. Journal of Health Care for the Poor and Underserved. Johns Hopkins University Press.
University of Oregon. “What is Cultural Humility? The Basics”
Yeager, Katherine A., and Bauer-Wu, Susan. (2013). “Cultural humility: Essential foundation for clinical researchers”. National Library of Medicine, NIH.