Cultural humility as a form of social justice: Promising practices for global school psychology training

Abstract

In an increasingly diverse global context in which school psychologists strive to ensure appropriate educational services for all, addressing social injustice is critical. Cultural humility can serve as a link between cultural diversity and social justice, providing a deep awareness that allows school psychologists to understand themselves and their interactions with diverse students and families. Additionally, cultural humility provides a lens for framing advocacy necessary to address social justice concerns. This article reviews the literature on cultural humility and suggests promising practices for training school psychologists as culturally humble practitioners.

Keywords

cultural diversity cultural humility school psychology social justice trainers

In recent years, the concept of cultural humility has emerged in health and mental health fields to help practitioners better address the needs of diverse individuals. Cultural humility is the keen awareness of how culture shapes all individuals’ experiences and perspectives, including the impact of power, privilege, and oppression (Fisher-Borne, Montana Cain, & Martin, 2015). This also includes practitioners’ understanding of how their own culture impacts their interactions with others (Fisher-Borne et al., 2015). In an increasingly interconnected and diverse global society, cultural humility can help school psychologists meet the needs of students and families from all backgrounds. Additionally, cultural humility and social justice are related constructs, given that many social injustices occur within the context of cultural diversity, such as systemic forces that reduce equitable access to resources for marginalized students (Shriberg & Clinton, 2016). Whereas social justice might be thought of as a broader framework promoting equitable, respectful, and culturally appropriate services and advocacy for social and systemic change (Shriberg & Clinton, 2016), cultural humility can be conceptualized as a “way of being” (Foronda, Baptiste, Reinholdt, & Ousman, 2016, p. 214) that allows the practitioner to become more fully aware of social injustices and to actively engage in socially just practice.

For professional psychologists and counselors, cultural diversity and social justice are often central themes in legal, ethical, and training standards. For example, the International School Psychology Association’s (ISPA, 2011) Code of Ethics highlights the need for school psychologists to (1) respect the rights and dignity of all people; (2) recognize the impact that culture (e.g., gender, race, religion, and sexual orientation) has on people; (3) ensure that all students have equitable access to free educational services; and (4) advocate for systemic changes to benefit all children. To meet these standards, practitioners must be keenly aware of how culture shapes all experiences. Thus, cultural humility can be understood as a link between cultural diversity and social justice in that it allows school psychologists to achieve a deeper understanding of diverse human experiences, which in turn enhances their effectiveness in advocating for equity and culturally responsive service delivery in schools. This article examines the concept of cultural humility and outlines promising practices for practitioners to develop cultural humility during their professional training.

The literature on cultural humility has emerged primarily in the United States (US), which is a substantial global entity in the field of school psychology that has a far-reaching impact on the broader international political context. Additionally, the US’s considerable history of oppression and intolerance continues to raise significant social justice concerns. In US schools, for example, African American students are more likely to be suspended and expelled than children of other races and ethnicities, and gender and sexual minority students experience higher levels of harassment and discrimination than their heterosexual, cisgender peers (National Association of School Psychologists, 2013, 2017). Thus, school psychology trainers across the globe may benefit from a deeper understanding of cultural humility and the work being done in the US to address ongoing social injustices impacting culturally diverse students and families.

Cultural humility

Cultural humility involves a lifelong process of critical reflection, self-awareness, and the development of personal attitudes that allow practitioners to build stronger working relationships and to more fully engage with diverse populations (Fisher-Borne et al., 2015). From this perspective, cultural differences do not exist within any one individual; rather, they exist in the interaction between people within systems (Hammell, 2013). This expanded understanding of culture diversity allows practitioners to view each individual’s experience as unique and as influenced by various aspects of their intersecting identities across contexts. In other words, it no longer serves practitioners to consider one aspect of an individual’s identity (e.g., sexual orientation) in isolation without also considering how other aspects of their identity and social contexts contribute to their unique experiences (Kirmayer, 2012). Further, practitioners cannot fully understand peoples’ lived experiences without being keenly aware of the social structures and power differences that impact them at individual and systemic levels (Fisher-Borne et al., 2015). Cultural humility focuses on developing characteristics that allow practitioners to approach individuals and situations with openness and awareness, to consider multiple perspectives simultaneously, and to use their positions to advocate for systemic change (Fisher-Borne et al., 2015).

In a recent concept analysis of cultural humility across health and mental health disciplines, Foronda et al. (2016) identified five key attributes:

Openness – The practitioner has an open mind, is open to engaging in cross-cultural interactions, and is open to new ideas.

Self-awareness – The practitioner has awareness of their own “strengths, limitations, values, beliefs, behavior, and appearance to others” (p. 211).

Egoless – The practitioner displays humbleness and modesty and believes that all people are equal.

Supportive interaction – The practitioner engages in interactions with others that result in positive exchanges.

Self-reflection and critique – The practitioner engages in a continual process of reflecting on aspects of self through deep introspection.

Foronda et al. (2016) noted that these characteristics of cultural humility were evident across a wide range of encounters with diverse individuals and situations, including those in which social injustices and power imbalances occurred. They further concluded that “cultural humility is a way of being” (p. 214). It is this all-encompassing embodiment of the concept that allows for the continual process of growth and reflection.

Cultural humility and cultural competence

The relationship between cultural humility and cultural competence can been conceptualized in three ways. First, cultural humility has been framed as an alternative to cultural competence that better accounts for the complexity of human diversity, experiences of power and privilege, and the need to advocate for systemic changes that impact marginalized individuals (Fisher-Borne et al., 2015). From this perspective, cultural competence is critiqued as being overly focused on: (1) developing knowledge of cultural differences (Johnson & Munch, 2009); (2) becoming comfortable in interacting with those who are different (Fisher-Borne et al., 2015) and; (3) using group membership as a proxy for cultural diversity (Kirmayer, 2012). When practitioners focus on those who differ from the dominant norm, they “ignore the fact that the basic concepts used to frame human problems and solutions have emerged from a particular cultural history or tradition and continue to bear the traces of that history” (Kirmayer, 2012, p. 150).

In contrast, Danso (2018) asserts that cultural humility is not a distinct concept, rather it is a repackaging of components of cultural competence and practices aimed at combating oppression. Danso argues that those who critique cultural competence fail to consider the intention of its original conceptualization and overlook more nuanced research in this area. Instead, these critics narrowly essentialize the components of knowledge, awareness, and skills in a way that does not reflect the wider literature on cultural competence. Danso concludes that these critiques lack “analytical rigour” (p. 417) and that the foundations of cultural humility are based in the very components of cultural competence that are being criticized.

This naturally leads to the third view, which frames cultural humility as a component of cultural competence (Danso, 2018) or as an intersecting complementary construct (Ortega & Faller, 2011). Sue and Sue (2016) stated that “cultural humility as a dispositional orientation may be equally important as cultural competence (awareness, knowledge, and skills) in multicultural counseling and therapy” (p. 63). This culturally humble “way of being” (Foronda et al., 2016, p. 214) can improve relationship development (Hook, Davis, Owen, Worthington, & Utsey, 2013) and collaboration (Juarez et al., 2006) with diverse individuals.

Cultural humility and social justice

Cultural humility and social justice are intersecting constructs. In their review of the literature on social justice in school psychology, Shriberg and Clinton (2016) highlight key themes that clearly connect with cultural humility. First, they describe social justice as the lens through which practitioners process information, helping them to consider how problems are embedded within larger sociopolitical contexts. Similarly, in their concept analysis on cultural humility, Foronda et al. (2016) concluded that “cultural humility involves a change in overall perspective” (p. 214). In this way, cultural humility might be thought of as the filter through which practitioners gain awareness of the impact of culture on virtually all aspects of being and understand how power and privilege perpetuate social injustices.

In summarizing the research on social justice in school psychology, Shriberg and Clinton (2016) identified a basic tenant related to respecting the rights and identities of all students. Similarly, cultural humility, at its core, is about valuing all aspects of the individual’s identity, respecting the individual’s expertise on themselves, and building effective partnerships in which the individual feels empowered (Foronda et al., 2016; Mosher et al., 2017). Practitioners do this by becoming aware of their own beliefs, biases, and values, understanding how such beliefs impact their ability to effectively engage with all people, and approaching all individuals and situations with openness and humility (Fisher-Borne et al., 2015; Mosher et al., 2017).

Finally, in their review, Shriberg and Clinton (2016) emphasize that social justice involves taking action to ensure equitable access to education and related services, both at the individual student and systems levels. A key aspect of cultural humility involves proactively challenging systemic power imbalances that impact individuals’ well-being and their ability to access services (Fisher-Borne et al., 2015; Hammell, 2013). This includes working to reduce structural forces—such as poverty, legal status, and homophobia—and institutional practices—such as expectations of family involvement—that impede access to services (Fisher-Borne et al., 2015). Cultural humility compels practitioners to be active change agents within the systems and institutions in which they work by openly discussing culture, diversity, and oppression, challenging policies and practices that maintain inequity, and committing to working with community leaders to ensure culturally appropriate service delivery (Fisher-Borne et al., 2015).

Research on cultural humility

In their often-cited pioneering work on cultural humility, Tervalon and Murray-Garcia (1998) stated that “existing literature documenting a lack of cultural competence in clinical practice most reflects not a lack of knowledge but rather the need for a change in practitioners’ self-awareness and a change in their attitudes toward diverse patients” (p. 119). The research on cultural humility is only beginning to emerge, providing some understanding of it as a viable construct for improving relationships between practitioners and their clients. This literature also has described techniques and activities that help promote cultural humility.

Within the research, an understanding of the characteristics that comprise cultural humility has emerged. As outlined previously, Foronda et al. (2016) identified the characteristics of openness, self-awareness, egolessness, supportive interactions, and self-reflection and critique as broad components of cultural humility. Similarly, Hook et al. (2013) conducted a series of studies to develop a measure of therapists’ cultural humility. From this research, a 12-item client-rated measure was developed and consisted of two factors: Positive Characteristics, such as being respectful, open-minded, genuinely interested in learning about the client, and open to asking questions and seeing things from the client’s perspective; and Negative Characteristics, such as making assumptions, acting superior, and acting as though they know or understand more than they actually do.

Using this measure of therapists’ cultural humility, additional research was conducted to examine the impact of cultural humility on the counseling relationship. Hook et al. (2013) found that higher ratings of therapists’ cultural humility were associated with more positive ratings of working alliance, even when controlling for ratings of therapists’ multicultural competencies. Further, they found that clients’ ratings of working alliances mediated the relationship between ratings of their therapists’ cultural humility and their perceived improvement in therapy; these findings highlight the critical importance of cultural humility in developing strong working relationships. In a related study, Owen et al. (2015) investigated the relations among clients’ ratings of their perceived improvement in therapy, their therapists’ cultural humility, and the extent to which their therapists missed opportunities to discuss their cultural identities. The authors found that perceptions of therapists’ cultural humility served as a buffer against negative treatment outcomes when clients felt that their therapists missed opportunities to discuss their cultural backgrounds and experiences in counseling (Owen et al., 2015). Finally, Hook et al. (2016) found that higher ratings of therapists’ cultural humility were associated with lower ratings of microaggressions in counseling, and when clients perceived microaggressions, there was less of a negative impact on the counseling relationship.

Another strand of research has emerged to document programs and activities to develop cultural humility among helping professionals. Kools, Chimwaza, and Macha (2014) described a diversity training program to promote cultural humility among health professionals in Malawi and Zambia with the goals of increasing understanding of cultural diversity in interpersonal interactions and integrating diversity into training and supervision. Qualitative responses from participants indicated that this training expanded their understanding of social status and marginalized groups, how their own beliefs and values shaped their interactions with others, and the need to address culturally insensitive behaviors among colleagues, supervisees, and mentees. Similarly, Juarez et al. (2006) evaluated a curriculum to promote cultural humility among medical students; this curriculum aimed to increase self-awareness and relationship building in interactions with diverse patients. Results indicated that the curriculum contributed to a more collaborative approach to working with patients during office visits, and the researchers concluded that providing time for structured learning activities and modeling of cultural humility by facilitators were important for the success of the program.

Two additional studies used reflective journaling to examine the development of cultural humility among nursing students engaging in community-based training experiences. Schuessler, Wilder, and Byrd (2012) examined students’ experiences in providing services to clients in low-income public housing, and Isaacson (2014) examined students’ experiences providing services on an American Indian reservation. In both studies, students were provided with specific reflective journal prompts at select points in their experiences to elicit their thoughts and feelings. Early prompts focused on expectations, assumptions, and beliefs and biases, while later prompts focused on the actual experiences they had, what they learned, and how the experiences impacted their development as professionals. After analyzing the journal entries across time, Schuessler et al. (2012) identified themes related to the importance of culture, the relationship between poverty and disparities in health care, power imbalances between patients and health care providers, and the importance of building partnerships with patients based on respect and understanding. Similarly, Isaacson (2014) found that early journal entries revealed judgmental and stereotyped thinking about American Indians, whereas later entries revealed students’ openness to challenging previously held beliefs and a greater understanding of the feelings of powerlessness that marginalized groups can experience. While still emerging, this research provides promising evidence for the positive impact of cultural humility on work with diverse clients as well as for practices that can help promote cultural humility among practitioners.

Promising practices for training

Training practitioners to embody cultural humility requires purposeful attention to (1) building self-awareness of biases, beliefs, values, power, privilege, and oppression; (2) providing supervised experiences in marginalized communities to promote supportive interactions with others in a manner that conveys genuine openness, collaboration, and partnership; and (3) teaching advocacy skills to address barriers and social injustices at the individual and systems levels (Fisher-Borne et al., 2015; Foronda et al., 2016; Mosher et al., 2017). In reviewing the research on multicultural training in school psychology, Newell et al. (2010) suggest that this type of training occurs through both focused coursework (e.g., courses devoted to multicultural studies that address knowledge, attitudes, and beliefs) as well as integrated training across all areas of graduate curricula. The following practices demonstrate promise for training, drawing from the literature on cultural humility, social justice, and other related concepts.

Structured learning activities

Drawing on a study of school psychology and social justice, Moy et al. (2014) highlight that “formal classroom-based coursework is crucially important … to form a theoretical foundation on which fieldwork is based” (p. 337). Similarly, Kirkland (2014) emphasized the value of classroom learning, concluding that “open and real conversations about bias must take place before we send … learners into fields of difference” (p. 594) in order to change rather than reinforce beliefs. Taken together, these structured learning activities are an indispensable component of training prior to engaging in cross-cultural experiences.

A key precondition for fostering cultural humility during structured learning activities is to create an environment in which it is safe to engage in deep and critical self-examination without shame or fear (Mosher et al., 2017). In fact, one of the criticisms of the cultural competency movement has been the message that to be ignorant or prejudiced is “wrong” and to be free of biases is “right” (Kumaş -Tan, Beagan, Loppie, MacLeod, & Frank, 2007). If cultural humility is truly viewed as an ongoing, lifelong process, then wherever the practitioner begins is exactly the right place. This is not to say that practitioners should not be encouraged or even challenged to question their beliefs; rather, this must be done in a thoughtful way in which it feels safe to be vulnerable and admit to views that might not be deemed socially acceptable. Instead of sending the message, “you shouldn’t think that way,” trainers want to send the message “let’s understand what has influenced you think that way.”

A number of scholars have considered the content that trainers should cover in their coursework to promote cultural humility among trainees. Content and activities designed to build self-awareness should help practitioners develop a deeper understanding of their cultural identities, how their cultural identities influence their worldviews, beliefs, and biases, and how their identities intersect with power, privilege, and oppression (Fisher-Borne et al., 2015; Mosher et al., 2017). Content designed to help practitioners engage in supportive interactions with others should help them critically examine how their own cultural backgrounds impact their professional beliefs, their theoretical orientations, their understanding of how and why people change, and their approaches to connecting with others and developing working relationships (Mosher et al., 2017). Finally, content to develop advocacy skills should educate trainees about (1) the ways in which various programs, practices, and interventions perpetuate inequity by failing to account for an individual’s culture and values; (2) strategies for working with community stakeholders to reconceptualize and develop more culturally appropriate practices; and (3) methods of advocating for change in institutional and societal structures that contribute to injustice and inequity (Constantine, Hage, Kindaichi, & Bryant, 2007). While the full extent of what this foundational coursework should entail is beyond the scope of this article, readers are encouraged to draw on relevant professional standards and literature for more detailed information (see Newell et al., 2010 and Ratts, Singh, Nassar-McMillan, Butler, & McCullough, 2016).

Perhaps one of the greatest challenges in developing cultural humility is balancing clinician and client expertise. In other words, practitioners and trainees must learn to recognize their own expertise while also equally valuing the expertise and differing worldviews that others (including clients) bring to various settings and interactions. Owen et al. (2015) suggest that one way to foster this balance is for practitioners to acknowledge their unique knowledge and skills “while simultaneously asking questions like ‘What if this is not the whole picture?’ ‘What might I be missing?’ that challenge them to listen more deeply and to recognize when they are inaccurate” (p. 6). In training, this type of culturally humble questioning can promote greater self-awareness as school psychologists seek to provide inclusive and equitable assessment, counseling, consultation, and other intervention services to children, families, and teachers.

Other structured learning activities for promoting cultural humility center on opportunities for trainees to learn from those with different experiences and worldviews as well as exercises designed to engage trainees in “meaningful sharing and self-exploration” (Juarez et al., 2006, p. 98). In a study by Juarez et al. (2006), effective activities included (1) a panel of gender and sexual minority individuals who spoke about their beliefs and experiences in health care, (2) a home visit with a conservative Muslim family and debrief with the faculty member, (3) a discussion about a book that described the conflict between a culturally diverse family and the medical system, and (4) a visit to a community agency serving seniors and a faculty-led discussion on healthy aging. Notably, such activities can be adapted for use not only with trainees but also with in-service practitioners. Overall, when combined with foundational coursework, direct contact with traditionally marginalized groups (in contexts that encourage empathy and openness) can deepen practitioners’ understanding of cultural humility.

Supervised placements in marginalized communities

Cultural humility cannot develop in isolation. It is critical that practitioners be exposed to marginalized populations and communities during fieldwork placements, such as practicum and internship. It also is critical that practitioners receive close supervision during these experiences (Jenkins, Shriberg, Conway, Ruecker, & Jones, 2018; Moy et al., 2014). Through close guidance, training, and supervision, practitioners can be supported in grappling with the complex cultural and sociopolitical implications of their experiences, identifying effective strategies to engage with students, families, and communities, and learning ways to overcome barriers to systemic change (Jenkins et al., 2018; Moy et al., 2014).

In a review of research on counseling supervision, Glosoff and Durham (2010) offered a variety of supervision strategies to assist trainees in developing critical consciousness and advocacy skills through their field-based experiences. For example, the authors noted that supervisors must intentionally and explicitly address issues of diversity, power, privilege, and oppression from the very beginning of the supervision process. In particular, they recommended the use of reflective questioning (i.e., technique in which supervisors pose questions designed to facilitate critical analysis of their supervisees’ practice) to promote awareness of personal biases and beliefs as well as social and systemic injustices. Finally, they recommended that supervisors assist trainees in identifying specific actions for effecting change. In particular, supervisors must “help supervisees understand the full range of advocacy work and develop comfort across this range” (p. 127), including work accomplished through vocal advocacy as well as through more subtle forms of resistance. As supervisors engage in this work, they must also continually strive to deepen their own cultural humility, thereby modeling these types of reflective practices for their supervisees (Hook, 2014).

Mindfulness meditation

Whether integrated into structured learning activities or supervision, mindfulness meditation has the potential to create greater openness, self-awareness, and self-reflection among practitioners. Mindfulness involves regulating one’s attention to be fully present in the immediate experience and to approach that experience with “curiosity, openness, and acceptance” (Bishop et al., 2004, p. 232). Mindfulness meditation may have value for promoting cultural humility and reducing cultural bias by (1) inhibiting the activation of implicit biases; (2) reducing stress and cognitive load, which make individuals more susceptible to implicit biases; and (3) increasing awareness and self-regulation when implicit biases are triggered (Burgess, Beach, & Saha, 2017).

In reviewing related research, Burgess et al. (2017) concluded that mindfulness has indeed shown promise for reducing implicit bias among heath (e.g., medical) professionals. Further, Lueke and Gibson (2015, 2016) found that college students who listened to a one-time 10-minute mindfulness recording focused on non-judgmental awareness and acceptance of bodily sensations demonstrated reduced implicit bias and prejudice during a subsequent implicit association test and trust game task. Similarly, Kang, Gray, and Dovidio (2014) found that volunteers who completed a six-week loving-kindness meditation class that included meditation practice and home practice demonstrated reduced implicit biases. While preliminary studies indicated that mindfulness meditation constitutes a promising approach to reducing implicit bias and increasing self-awareness, further research is needed to examine their direct utility for promoting cultural humility. Moreover, research has yet to clarify a variety of logistical considerations (e.g., frequency and duration of interventions) related to using mindfulness meditation to combat implicit biases (Burgess et al., 2017).

Global implications and conclusions

When examining global school psychology practice through the lenses of cultural humility and social justice, we must acknowledge that both are “culture-specific aspiration[s]” (Shriberg & Clinton, 2016, p. 333) that primarily reflect Western ideology. Similarly, ISPA’s Code of Ethics (2011) and International Guidelines for the Preparation of School Psychologists (n.d.) generally mirror the language of Western professional organizations. In considering the relations between cultural humility and social justice, the key idea may be perspective. Thus, what is deemed “socially just” in any given situation may depend upon whose perspective is taken. If the dominant perspective of what is regarded as socially just is allowed to overshadow the perspectives of those who have been historically marginalized, the very social structures and institutional forces that created such power differentials are likely to be maintained (Hammell, 2013; Kirmayer, 2012; Shriberg & Clinton, 2016). Weaver (2014) illustrated this notion in a discussion of social justice for indigenous peoples in the aftermath of colonization. Specifically, Weaver noted that traditional Western perspectives of social justice, which focus on legal rights, financial compensation, and full integration as citizens, generally are incompatible with indigenous perspectives, which focus on the restoration of lands, reclaiming autonomy, and rebuilding a strong indigenous society. As Weaver (2014) concluded, there is no simple solution to reconciling these perspectives; however, practitioners must work to restore balance between dominant and marginalized populations and to treat all people with respect and dignity.

Practitioners who display cultural humility demonstrate awareness that perspectives on the meaning of social justice are shaped by values and culture. Overall, it is important for school psychology leaders in all parts of the world to collaborate with local community leaders to: (a) examine how school psychology is or could be conceptualized to best reflect current conditions and goals for educational reform, (b) identify what aspects of school psychology practice are working to address the needs of all students and families, and (c) consider what needs to be changed so that educational services are accessible and acceptable within the local community. Such discussions may encourage leaders and practitioners alike to rethink their conceptualization of key issues and to work toward mutual understandings of socially just school psychology practice. Ultimately, cultural humility is an important tool for framing these discussions and for preparing competent school psychology practitioners who are able to challenge injustice at the local, national, and/or international levels.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Emily S. Fisher .

Emily S. Fisher, PhD, is a Professor in the Department of Specialized Programs in Professional Psychology at Loyola Marymount University. She teaches courses in the School Psychology and Counseling graduate programs on counseling and treatment with a focus on children and adolescents. Dr Fisher has published extensively on school-based supports for LGBTQ youth. Her most recent book, Counseling Special Populations in Schools, addresses strength-based approaches to build resilience among highly marginalized young people, including those who are homeless and living in foster care. Dr Fisher is also interested in methods to develop cultural humility among pre-service professionals. Her experience working in clinical, juvenile justice, and school settings informs her work. She can be reached at emily.fisher@LMU.edu.

References

Bishop

S. R.

Lau

Shapiro

Carlson

Anderson

N. D.

Carmody

Devins

(2004) Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice 11(3): 230–241. doi:10.1093/clipsy/bph077.

Burgess

D. J.

Beach

M. C.

Saha

(2017) Mindfulness practice: A promising approach to reducing the effects of clinician implicit bias on patients. Patient Education and Counseling 100(2): 372–376. doi:10.1016/j.pec.2016.09.005.

Constantine

M. G.

Hage

S. M.

Kindaichi

M. M.

Bryant

R. M.

(2007) Social Justice and multicultural Issues: Implications for the practice and training of counselors and counseling psychologists. Journal of Counseling & Development 85(1): 24–29. doi:10.1002/j.1556-6678.2007.tb00440.x.

Danso

(2018) Cultural competence and cultural humility: A critical reflection on key cultural diversity concepts. Journal of Social Work 18(4): 410–430. doi:10.1177/1468017316654341.

Fisher-Borne

Montana Cain

Martin

S. L.

(2015) From mastery to accountability: Cultural humility as an alternative to cultural competence. Social Work Education 34(2): 165–181. doi:10.1080/02615479.2014.977244.

Foronda

Baptiste

Reinholdt

M. M.

Ousman

(2016) Cultural humility: A concept analysis. Journal of Transcultural Nursing 27(3): 210–217. doi:10.1177/1043659615592677.

Glosoff

H. L.

Durham

J. C.

(2010) Using supervision to prepare social justice counseling advocates. Counselor Education & Supervision 50: 116–129. doi:10.1002/j.1556-6978.2010.tb00113.x.

Hammell

K. R.

(2013) Occupation, well-being, and culture: Theory and cultural humility. Canadian Journal of Occupational Therapy 80(4): 224–234. doi:10.1177/0008417413500465.

Hook

J. N.

(2014) Engaging clients with cultural humility. Journal of Psychology and Christianity 33(3): 277–280. Retrieved May 6, 2019 from https://www.questia.com/library/journal/1P3-3455030991/engaging-clients-with-cultural-humility.

10.

Hook

J. N.

Davis

D. E.

Owen

Worthington

E. L.

Jr. Utsey

S. O.

(2013) Cultural humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology 60(3): 353–366. doi:10.1037/a0032595.

11.

Hook

J. N.

Farrell

J. E.

Davis

D. E.

Deblaere

Tongeren

D. R.

Utsey

S. O.

(2016) Cultural humility and racial microaggressions in counseling. Journal of Counseling Psychology 63(3): 269–277. doi:10.1037/cou0000114.

12.

International School Psychology Association (ISPA). (2011). Code of ethics. Retrieved May 6, 2019 from http://www.ispaweb.org/wp-content/uploads/2013/01/The_ISPA_Code_of_Ethics_2011.pdf.

13.

International School Psychology Association (ISPA). (n.d). International guidelines for the preparation of school psychologists. Retrieved May 6, 2019 from http://www.ispaweb.org/guidelines-for-the-preparation-of-school-psychologists/.

14.

Isaacson

(2014) Clarifying concepts: Cultural humility or competency. Journal of Professional Nursing 30(3): 251–258. doi:10.1016/j.profnurs.2013.09.011.

15.

Jenkins

K. V.

Shriberg

Conway

Ruecker

Jones

(2018) Bringing social justice principles to practice: New practitioners speak. Contemporary School Psychology 22(1): 63–76. doi:10.1007/s40688-017-0129-y.

16.

Johnson

Y. M.

Munch

(2009) Fundamental contradictions in cultural competence. Social Work 54(3): 220–231. doi:10.1093/sw/54.3.220.

17.

Juarez

J. A.

Marvel

Brezinski

K. L.

Glazner

Towbin

M. M.

Lawton

(2006) Bridging the gap: A curriculum to teach residents cultural humility. Family Medicine 38(2): 97–102. Retrieved from https://www.montefiore.org/documents/Bridging-the-Gap-A-Curriculum-to-Teach-Residents-Cultural-Humility.pdf.

18.

Kang

Gray

J. R.

Dovidio

J. F.

(2014) The nondiscriminating heart: Lovingkindness meditation training decreases implicit intergroup bias. Journal of Experimental Psychology: General 143(3): 1306–1313. doi:10.1037/a0034150.

19.

Kirkland

D. E.

(2014) “They look scared”: Moving from service learning to learning to serve in teacher education – A social justice perspective. Equity & Excellence in Education 47(4): 580–603. doi:10.1080/10665684.2014.958967.

20.

Kirmayer

L. J.

(2012) Rethinking cultural competence. Transcultural Psychiatry 49(2): 149–164. doi:10.1177/1363461512444673.

21.

Kools

Chimwaza

Macha

(2014) Cultural humility and working with marginalized populations in developing countries. Global Health Promotion 22(1): 52–59. doi:10.1177/1757975914528728.

22.

Kumaş -Tan

Beagan

Loppie

MacLeod

Frank

(2007) Measures of cultural competence: Examining hidden assumptions. Academic Medicine 82(6): 548–557. doi:10.1097/acm.0b013e3180555a2d.

23.

Lueke

Gibson

(2015) Mindfulness meditation reduces implicit age and race bias. Social Psychological and Personality Science 6(3): 284–291. doi:10.1177/1948550614559651.

24.

Lueke

Gibson

(2016) Brief mindfulness meditation reduces discrimination. Psychology of Consciousness: Theory, Research, and Practice 3(1): 34–44. doi:10.1037/cns0000081.

25.

Mosher

D. K.

Hook

J. N.

Captari

L. E.

Davis

D. E.

Deblaere

Owen

(2017) Cultural humility: A therapeutic framework for engaging diverse clients. Practice Innovations 2(4): 221–233. doi:10.1037/pri0000055.

26.

Moy

G. E.

Briggs

Shriberg

Furrey

K. J.

Smith

Tompkins

(2014) Developing school psychologists as agents of social justice: A qualitative analysis of student understanding across three years. Journal of School Psychology 52(3): 323–341. doi:10.1016/j.jsp.2014.03.001.

27.

National Association of School Psychologists. (2013). Racial and ethnic disproportionality in education (Position statement). Bethesda, MD: Author. Retrieved May 6, 2019 from https://www.nasponline.org/resources-and-publications/resources/diversity/disproportionality.

28.

National Association of School Psychologists. (2017). Safe and supportive schools for LGBTQ+ youth (Position statement). Bethesda, MD: Author. Retrieved May 6, 2019 from https://www.nasponline.org/resources-and-publications/resources/diversity/lgbtq-youth.

29.

Newell

M. L.

Nastasi

B. K.

Hatzichristou

Jones

J. M.

Schanding

G. T.

Jr. Yetter

(2010) Evidence on multicultural training in school psychology: Recommendations for future directions. School Psychology Quarterly 25(4): 249–278. doi:10.1037/a0021542.

30.

Ortega

R. M.

Faller

K. C.

(2011) Training child welfare workers from an intersectional cultural humility perspective: A paradigm shift. Child Welfare 90(5): 27–49. Retrieved from http://www.academia.edu/14128356/Cultural_Humility_for_Child_Welfare_Professionals_A_Paradigm_Shift.

31.

Owen

Tao

K. W.

Drinane

J. M.

Hook

Davis

D. E.

Kune

N. F.

(2015) Client perceptions of therapists’ multicultural orientation: Cultural (missed) opportunities and cultural humility. Professional Psychology: Research and Practice 47(1): 30–37. doi:10.1037/pro0000046.

32.

Ratts

M. J.

Singh

A. A.

Nassar-McMillan

Butler

S. K.

McCullough

J. R.

(2016) Multicultural and social justice counseling competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling and Development 44: 28–48. doi:10.1002/jmcd.12035.

33.

Schuessler

J. B.

Wilder

Byrd

L. W.

(2012) Reflective journaling and development of cultural humility in students. Nursing Education Perspectives 33(2): 96–99. doi:10.5480/1536-5026-33.2.96.

34.

Shriberg

Clinton

(2016) The application of social justice principles to global school psychology practice. School Psychology International 37(4): 323–339. doi:10.1177/0143034316646421.

35.

Sue

D. W.

Sue

(2016) Counseling the culturally diverse: Theory and practice, (7th ed.). Hoboken, NJ: Wiley.

36.

Tervalon

Murray-García

(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 9(2): 117–125. doi:10.1353/hpu.2010.0233.

37.

Weaver

H. N.

(2014) Indigenous struggles for justice. In: Reisch

(eds) The Routledge international handbook of social justice, New York, NY: Routledge, pp. 111–122.