The Importance of Building Trust and Use of Language in Diagnostics and Treatment

Enhancing Therapeutic Relationships Through Cultural Sensitivity

When exploring spirituality or any other aspect of a patient’s identity, it is critical for clinicians to foster a safe and supportive environment.

In this session, Coyne and Vahia describe how mental health professionals can practice open communication and find opportunities for learning within their clinical practice.

Watch now to learn more about:

• Why cultural humility is important
• How culture relates to identity
• How culture, faith, and mental health intersect in complex ways

In their discussion, Coyne and Vahia help the audience understand the significance of culturally sensitive language and its role in accurate diagnosis and effective therapy.

They also explore how spiritual beliefs and practices can be a source of strength for patients, and how talking about spirituality and religion can enhance the therapeutic relationship.

When providers explore matters of identity in therapy, it is important to let patients take the lead.

According to Coyne and Vahia, cultural humility is at the heart of such interactions. Clinicians should remain open to what they don’t know about patients’ lives, and they should take care not to make assumptions.

“It’s really important that we approach each individual in our offices as an individual, and be very aware of our own assumptions based on how someone looks, what labels they use, and to hold all of those things lightly,” shares Coyne.

“It’s also important that we understand how our presentation might affect their ability to engage with us just by virtue of how we look, how we speak, what socioeconomic, religious, or whatever background we have, and how much of that is apparent,” she adds.

When therapists and patients have similar cultural backgrounds, it can be helpful in fostering a sense of safety for patients. However, such matches are not always possible due to disparities in the availability and accessibility of care.

Vahia points out that culture is not one thing.

“Each of us has so many elements to our identities, and it’s not always clear which one has a higher weight in the course of a specific treatment or an interaction with a therapist,” he says.

He points out that for one patient, gender may be more important; for another, race may be more important; for yet another, religious background may be the most important aspect of identity.

“All cultures are not represented in the realm of professional expertise,” Vahia says, “so I think openness and an ability to learn and be humble is a bigger factor.”

With such openness, clinicians can begin to explore how patients’ cultural backgrounds and beliefs intersect with mental health.

Audience Questions

• How can professional and personal journeys shape the way we view culture?
• How do patient identities and values intersect? Why are they both so important in treatment?
• What does the research tell us about addressing cultural identities in treatment?
• What does the term “cultural competence” get at? How does it factor into this conversation? Are there other terms we should think about using instead?
• Is mental health care most effective when the patient and provider share a cultural background? Is that match always realistic to look for?
• Do you find that most individuals identify strongly with their culture?
• In cases where an individual’s personal identities are strong, how can that impact mental health treatment?
• How might one’s faith impact their views on mental health and treatment?
• How can sexual identity interact with other aspects of one’s identity? How can that impact mental health treatment?
• What are digital approaches to medicine missing when it comes to taking culture and other identity factors into account?
• How do you address mental health stigma that’s culturally based?
• Can personal identities appear intertwined in mental health challenges such as scrupulosity in OCD?
• How can clinicians differentiate a person’s intense spiritual experiences from possible mental health challenges such as psychosis?
• Is there a particular approach clinicians can use to help patients understand that one can both have faith and engage in mental health treatment?
• Can you speak to how certain words or phrases might be sensitive when it comes to cultural identity?
• Is it okay for a clinician to apologize to a patient if they suspect they’ve offended them?
• To what degree is it appropriate to proactively bring up the topic of cultural or spiritual identity in therapy? How might a clinician go about doing that with a patient?
• How can clinicians set up personal boundaries for themselves surrounding their own identity?
• Are there situations where we may want to seek care from someone unlikely to have preconceptions about our cultural identity?
• What if a younger patient’s parents present cultural, spiritual, or personal identity treatment challenges? How might a clinician address those?
• What role should faith leaders aim to play in mental health care?
• How can highlighting the similarities between our cultures, backgrounds, and spiritual beliefs be useful in a treatment setting?
• How has this field changed in how it involves identity and how is it still growing?
• Do you find that age impacts what patients bring to treatment regarding identity considerations?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

Resources

You may also find this information useful:

• Video: Cultural Competency and the Importance of Curiosity
• Video: Why Words Matter in Mental Health Care
• Understanding Spirituality and Mental Health
• When Eastern Practices Meet Western Psychology
• Video: Building Trust With Patients
• Let’s Face It, No One Wants To Talk About Mental Health
• What Is Self-Compassion and How Can We Cultivate It?

About Dr. Coyne

Lisa W. Coyne, PhD, is an assistant professor of psychology in the Department of Psychiatry, part-time, at Harvard Medical School, and is a senior clinical consultant at the Child and Adolescent OCD Institute (OCDI Jr.) at McLean Hospital.

She is a licensed clinical psychologist, an internationally recognized acceptance and commitment therapy (ACT) trainer, and the author of “The Joy of Parenting: An Acceptance and Commitment Therapy Guide to Effective Parenting in the Early Years,” a book for parents of young children.

About Dr. Vahia

Ipsit Vahia, MD, is a geriatric psychiatrist, clinician, and researcher. He is the interim chief of the Division of Geriatric Psychiatry and director of Digital Psychiatry Translation at McLean Hospital. He is also director of the Technology and Aging Laboratory. His research focuses on the use of technology and informatics in the assessment and management of older adults.

Dr. Vahia has published extensively in major international journals and textbooks and serves on the American Psychiatric Association (APA) Council on Geriatric Psychiatry and the Geriatric Psychiatry Committee of the American Board of Psychiatry and Neurology.