Cultural Humility, Gambling Disorders and Gaming

At Kindbridge, we practice cultural humility in our therapeutic relationships with clients and their families. This blog – in partnership with Dr. Stephanie Diez-Morel, Founder of Reboot & Recover – explains the concept and outlines our ongoing commitment to cultural humility in the mental health treatment of gaming and gambling issues.

What is cultural humility?

The term “cultural humility” was first introduced by Tervalon & Murray-Garcia (1998). They outlined the following three factors that can guide healthcare professionals towards cultural humility:

  • A lifelong commitment to self-evaluation and self-critique
  • A desire to fix power imbalances where none ought to exist
  • An aspiration to develop partnerships with people and groups who advocate for others

Cultural humility has since been studied further to help therapists and mental health practitioners combine multicultural practices with their own lived experience. The concept encourages them to meaningfully engage with clients and their cultural identities, for better therapeutic outcomes.

Furthermore, Davis et al. (2011) divide cultural humility into intrapersonal humility and interpersonal humility. They recognize that to practice cultural humility, we must have an accurate view of ourselves and respect for others without an attitude of supremacy or superiority.

To sum it up, Hook et al. (2013) conceptualize cultural humility as the “ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the person.”

Cultural humility versus cultural competency

When Tervalon & Murray-Garcia (1998) introduced the concept of cultural humility over 30 years ago, they started an ongoing debate about whether cultural humility is more important than cultural competency. They argued that “culture” should not be restricted to racial or ethnic identity, but should include the culture of the mental health professional, who also requires humility in dealing with clients.

Indeed cultural competency has two clear limitations. First, the term suggests there is definitive knowledge to be gained about a group of people which can lead to stereotyping and bias. Second, it implies there is an endpoint to becoming culturally competent.

In contrast, cultural humility encourages ongoing curiosity. It involves trying to understand the complexity of each client’s cultural identity and realizing that mental health professionals will never know everything about other lives and cultures. They should approach learning about other cultures and experiences as a lifelong goal and process.

Cultural humility – a stronger therapeutic alliance

Dr Stephanie Diez-Morel (pronouns: she/her), Founder of Reboot & Recover, illustrates the difference between cultural competence and cultural humility. She explains that many mission and vision statements of therapists and companies often focus on being aware of our differences, engaging in ethical practices and in the importance of being culturally competent . However, she acknowledges that the term cultural competence implies that there is a threshold  which a therapist or company seeks to meet the qualification of being competent in their understanding of people who identify as belonging to varying cultures in terms of categories such as race, gender, ethnicity, religion, sexual orientation, etc. But is that realistic?

Dr Stephanie Diez-Morel considers that most therapists are managing ethics, psychopharmacology, varying theoretical frameworks and psychopathology on a regular basis when treating clients with a wide range of psychosocial complications and issues. Thus, with the vast knowledge that needs to be implemented and constantly updated by therapists, it is not probable to also be completely versed in their clients’ cultural norms, expectations, and perspectives. Even if the therapist is part of a similar culture, what the client is experiencing is subjective and unique to them. She says that “Instead, practicing cultural humility – while being aware of and respectful of others’ intersections – expands beyond uni-dimensional thinking and encompasses the complexity of human experiences. Our ability to see the many parts of us that make us unique, can allow for a stronger human connection and therapeutic alliance.” Dr. Diez-Morel adds: “Therapeutic education and practice often relies on a uni-dimensional approach which can pathologize a behavior rather than examining a person in their environment and considering how all the systems they interact (e.g. family, friends, work, society) are affecting them.”

Cultural humility in the treatment of gaming and gambling issues

So, how does cultural humility relate to the treatment of gambling and gaming disorders? Kindbridge therapist, Dr Deborah G. Haskins, explains our approach: “Gambling is a universal entertainment and social experience. Gaming is increasingly popular due to the ease of accessibility. We often see people, families and communities experiencing the negative consequences of gambling and gaming. Can we reflect on cultural identities and experiences, understand the range of motivations to gamble and game, and integrate their lived cultural experiences in our prevention and treatment? Well, here at Kindbridge, we maintain a cultural humility stance and will honor all cultures. Yes we are ‘attuned’ to cultural humility. Humility is key to disordered gambling and gaming recovery, and humility is key to cultural understanding and honoring too.”

Kindbridge advisor, Dr Timothy Fong, says: “Gambling in Asian American families and communities is greatly influenced by a mix of Asian history, culture and values. Understanding, appreciating and recognizing how cultural factors influence mental health treatment among Asian Americans is a critical priority for therapists as it will impact treatment outcome and retention. Research has consistently shown that improved cultural humility results in improved treatment experience for clients, therapists and family members.“

The Kindbridge approach to cultural humility

Historically, many mental health professionals are ill equipped to help clients who are struggling with problematic gaming and gambling behaviors. When working with these diverse populations, it is important to practice cultural humility and be respectful of each client’s unique needs and cultural values. At Kindbridge, we approach every therapeutic relationship with cultural humility, acknowledging that we are always in the process of learning and growing.

In an effort to diversify and amplify the voices of those who are underrepresented in the mental health field, we actively recruit people who identify as being members of ethnically diverse cultures. By engaging clients who also identify as members of these communities, we aim to increase access to better mental health care for all.

Find out more

For further information about the wide range of mental health services offered by Kindbridge – including specialist gambling and gaming treatment, contact one of our Care Coordinators today.