The Importance of Cultural Sensitivity in Therapy
By Bhavesh Kotecha, Integrative Psychotherapist, Therapist Trainer & Chartered Accountant
As a therapist who has navigated both the corporate world and the therapeutic space, I’ve often reflected on the layers people carry into the rooms their enter - layers that are shaped by culture, family, community, lived experience and more.
We don’t arrive into therapy with a set of malleable principles that can be easily erased and reformed. We arrive as people formed by a complex interplay of values, beliefs, expectations, and unspoken rules - many of which are deeply cultural and rooted in the unconscious. We may not even be aware of just how much our culture has given us a rulebook for living our lives.
And yet, these cultural influences can often go unchecked in therapy.
When I talk about culture, I’m not only referring to ethnicity or nationality. I’m talking about the broader cultural systems we move through: family roles, religious beliefs, gender expectations, migration stories, class backgrounds, and the internalised scripts about what it means to be "successful", "respectable", or even “strong”. The rules of life we may have adopted without consciously realising or acknowledging just how profoundly they have informed our worldview and the decisions we have taken.
Why Cultural Sensitivity Matters
Too often, therapy has been rooted in models that assume a universal experience of human emotion or development - models largely developed without a full understanding of the cultural contexts many people live in. This can result in clients feeling unseen, or worse, pathologised for ways of being that actually make perfect sense within their cultural frameworks.
Culture rarely exists in isolation - it intersects with other layers of identity such as gender, sexuality, class and religion. This intersectionality shapes the way we experience ourselves and the world. A woman navigating a demanding corporate career may also be managing religious expectations around modesty and family, as well as class mobility pressures from being the first in her family to enter a professional field. Therapy that holds space for this complexity allows clients to make sense of seemingly conflicting roles without having to choose one identity over another.
Take, for example, a client who feels torn between loyalty to family and the desire for personal freedom. In some cultural contexts, family obligation isn’t just encouraged - it’s foundational. Therapy that doesn’t acknowledge this might mistakenly frame the client’s struggles as enmeshment or lack of boundaries. Or that family obligation is at the root of their issues and untangling themselves from this burden will lead to ultimate freedom from their tension.
But a culturally informed lens sees this tension as part of a larger negotiation between personal and collective identity. It acknowledges familial scripts as an intrinsic part of the client’s identity and that any therapeutic shifts will need to consider the impact of going against the cultural blueprint – as well considering the compromises that are possible. The cultural lens does not assume anything – it leans into the challenges faced by the client to consider what is possible within their cultural framework.
The Cultural Self in the Therapy Room
In my own practice, I work with clients who, like myself, often straddle multiple worlds. Perhaps they are professionals in high-pressure fields like finance or law - environments that reward detachment and performance. But at home, they may be the eldest son expected to provide support, or the daughter navigating unspoken generational expectations. They might have been the first ones to go to university and unknowingly carry their family’s hopes and dreams. They might be the children of immigrants or refugees and shaped by the second generational guilt of not having to suffer the same hardship as their parents. Exploring these unwritten roles gives meaning to the client’s own story and could uncover just why these cultural expectations feel so heavy. This is before we even consider the traumas that could be passed down generations and further influence how they approach the world.
There is often an invisible emotional labour involved in managing these various identities - a labour that deserves attention in therapy.
Being culturally sensitive doesn’t mean assuming anything about a client’s identity. It means staying curious. It means being willing to ask, “What does this mean for you, in your world?” rather than interpreting experiences through a narrow lens. It’s about gently exploring possibilities, “What feels negotiable for you, and what feels non-negotiable.” These questions not only validate the client’s cultural context but also empower them to explore their own values and boundaries in a way that feels respectful.
It’s about understanding that people bring their full selves to therapy - not just their symptoms, but their stories, their histories, and their cultural contexts. Some of these may have passed down generations or come from their wider community.
Cultural sensitivity also invites us as therapists to reflect on our own worldviews. We, too, carry cultural scripts into the therapy room - beliefs about autonomy, respect, emotional expression, and what constitutes a “healthy” relationship. Becoming aware of our own assumptions allows us to notice when they might be influencing the questions we ask or the directions we gently encourage. This process of self-reflection is not about erasing who we are as therapists, but about creating more room for the client’s reality to take centre stage.
Cultural Sensitivity Is Not an Add-On - It’s Fundamental
Therapy should be a space where people can feel safe enough to bring all of who they are. For that to happen, cultural understanding can’t be treated as a side-note. It must be central to the way we listen, reflect, and respond.
As therapists, our role isn’t to know everything about every culture. Our role is to remain open - to let our clients lead us into their worldviews, not impose our own. That’s where trust is built. That’s where meaningful change begins and the client’s story unfolds.
Final Thoughts
In my journey from the boardroom to the therapy room, I’ve come to see how essential it is to hold space for cultural complexity. We are never just one thing - and neither are our clients. The more we make room for cultural nuance in therapy, the more healing becomes possible.
If you’re reading this and wondering whether therapy can truly accommodate your full story - know that it can, and it should. Therapy isn’t about leaving parts of yourself at the door. It’s about being welcomed in your entirety.
