Cultural Humility as a Tool for Change

by Dionardo Pizana

In an article that appears in the Journal for Health Care for the Poor and Underserved, authors Melanie Tervalon and Jann Murray-Garcia advocate that the work of individuals, and the support they receive from their institutions around issues of inclusion, equity and social justice, suggest people should support the development of cultural humility rather than cultural competence when working across differences.  The authors define cultural humility as “a lifelong process and commitment to self-evaluation and critique, to redressing the power imbalances in the caretaker-patient dynamic, and to developing mutullay beneficial and non-paternalistic relationships and partnerships with communities on behalf of individuals and underrepresented populations.” Components that support the development and sustainabilty of cultural humility include:

* Prioritizing self-reflection and a lifelong learner model in one’s personal and professional lives – It is imperative that there be a simultaneous process of self-reflection and ongoing self-appraisal as it relates to addressing one’s own culture and how that impacts a person’s ability to work authentically across differences.


* Recognizing and challenging power imbalances for respectful partnerships — while working to establish and maintain respect is essential in all healthy and productive relationships, the root of effective practices is in acknowledging and challenging the power imbalances inherent in our practitioner/client dynamics.

* A movement from the “expert” model to the “student” model – Individuals with power need to be flexible enough and humble enough to “say that they do not know when they truly do not know,” and become students with their clients to better understand when one’s culture is at play and when other issues such as racism, sexism, homophobia, classism or other larger issues are impacting one’s health.

 * Community-based direction and advocacy – Practitioners of cultural humility work toward optimal health in their communities addressing the physical, mental and social well-being of their communities.  They work toward being nonpaternalistic, mutually engaged and mutually respectfull and build on the assests and adaptive strengths of communities - including those who are too often disenfranchised. 

* Institutional accountability — organizations need to model these principles as well (from micro, to mezzo and macro practice)

Although this model and way of being was developed within a medical community and framework, I believe that it can be applied in many of our personal and professional settings.  Questions that may help us to reflect on the concept of cultural humility in our personal and professional lives, include:

 -          How does the notion of cultural humility connect with your work in building authentic and sustained relationships across differences?

-           What is my professional responsibilty to build the skills and approaches connected to operating with cultural humility and what is the cost to me personally or to those that I work with if I don’t operate from a place of cultural humility? 


-          How does/could operating with cultural humility strengthen or support my work with diverse communities? 


Post some of your thoughts in the comment section.

 A video providing further information on cultural humility can be found at:

http://www.youtube.com/watch?v=SaSHLbS1V4w