Module 5: Cultural Considerations

With online therapy, we continue to provide support to people further and further afield. We must recognise that as we move to a larger geographic footprint, we will encounter new cultures and new points of view. Our practice will need to adjust according to differences in culture, so that the client and the client’s circle of support can get the most out of the relationship.

Cultural Safety:

Cultural safety is the concept that one is safe and secure in identity, culture, and community. Allied health professionals should provide a culturally safe experience to all clients, not only because it will be important to each client, but it also leads to more meaningful outcomes for that person and their circle of support. It is important to remember that the clinician does not decide what is cultural safe, the focus person does – what you might think is culturally safe might not be, so we must be led by our clients and their support networks to define what is culturally safe in each individual situation.

Steps to defining and exploring cultural safety with your client:

 1.     Be respectful – if your client doesn’t feel comfortable exploring certain topics, don’t push it. Make sure that you acknowledge their expertise in their culture, and that you are an outsider.

2.     Explore local culture and customs – read widely, ask connections and colleagues if they have experiences with that particular culture and what they learned.

3.     Share of yourself before asking clients to share with you – How do you define your own culture? Where do you come from? What matters to you?

4.     Explore what culture, customs, and language mean to your client. How would they recommend that you can learn more about their cultural outside of consultations?

5.     Don’t isolate this conversation to one occasion. Make sure it’s ongoing throughout the therapeutic relationship.

Features of communication to look for (Fryer-Smith, 2008):

 Different cultures communicate in different ways. Elements of our communication that might differ can include (but are not limited to) the list below. Use the points in the section above to observe, discuss, and explore these differences so that you and your client can communicate together effectively.

  • forms of greeting and leave-taking; 

  • use of names and titles; 

  • deference to authority or seniority; 

  • eye contact; 

  • silence; 

  • modesty; 

  • physical touch; 

  • directness in speech and in asking questions; 

  • the right to seek and the obligation to impart knowledge. 


Online therapy tip:

Many cultures use eye contact sparingly, and direct eye contact can sometimes be seen as a sign of confrontation or disrespect. If you’re working with people from a culture where this might be the case, it may be more appropriate to look away, or focus on using less direct modes of online therapy like phone calls or video sharing.