Cultural Competency in the Primary Care Setting

  • Melanie P. Duckworth
  • Tony Iezzi
  • Aditi Vijay
  • Erika Gerber

Culturally competent health care provision necessarily requires recognition of the range of cultural factors that are present and active in the context of health care delivery (Duckworth & Iezzi, 2005). Although health care providers commonly deal with patients of different cultures, they often neglect to focus on the effects of cultural influences on health care provision. In an idealistic spirit of “we are all the same,” some health care providers purposefully ignore the myriad of cultural factors that are relevant to effective patient care. The aims of the current chapter are (1) to assist health care providers in identifying cultural factors, present in both providers and patients, that have the potential to influence providers’ delivery of care and patients’ implementation of health care recommendations; (2) to identify strategies through which providers may evaluate the influence of cultural biases and preconceptions on their provision of health care to culturally diverse...


Health Care Provider Cultural Difference Health Care Delivery Cultural Competency American Psychological Association 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. American Psychological Association (1993). Guidelines for providers of psychological services to ethnic, linguistic, and culturally diverse populations. American Psychologist, 48 45–48. Google Scholar
  2. American Psychological Association (2000). Guidelines for psychotherapy with lesbian, gay, and bi-sexual clients. American Psychologist, 55, 1440–1451. Google Scholar
  3. American Psychological Association (2003a). Guidelines and multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58, 377–402. Google Scholar
  4. American Psychological Association (2003b). Guidelines for psychological practice with older adults. Guidelines for Psychological Practice with Older Adults. Washington, DC: Author. Google Scholar
  5. Atkinson, D. R., Morten, G., & Sue, D. W. (1993). Counseling American minorities: A cross-cultural perspective. Dubuque, IA: William C. Brown.Google Scholar
  6. Betancourt, H., & Lopez, S. R. (1993). The study of culture, ethnicity, and race in American psychology. American Psychologist, 48, 629–637.CrossRefGoogle Scholar
  7. Burkard, A. W., & Knox, S. (2004) Effect of therapist color-blindness on empathy and attributions in cross-cultural counseling. Journal of Counseling Psychology, 51, 387–397.CrossRefGoogle Scholar
  8. Cardemil, E. C., & Battle, C. L. (2003). Guess who’s coming to therapy? Getting comfortable with conversations about race and ethnicity in psychotherapy. Professional Psychology: Research and Practice, 34, 278–286.CrossRefGoogle Scholar
  9. Chibnall, J. T., Tait, R. C., Andresen, E. M., & Hadler, N. M. (2005). Race and socioeconomic differences in post-settlement outcomes for African American and Caucasian Workers’ Compensation claimants with low back pain. Pain, 114, 462–472.PubMedCrossRefGoogle Scholar
  10. Council of National Psychological Associations for the Advancement of Ethnic Minority Issues (2000). Guidelines for Research in Ethnic Minority Communities. Washington, DC: American Psychological Association.Google Scholar
  11. Council of National Psychological Associations for the Advancement of Ethnic Minority Interests (2003). Psychological Treatment of Ethnic Minority Populations. Washington, DC: Association of Black Psychologists.Google Scholar
  12. Daniel, J. H., Roysircar, G., & Abeles, N. (2004). Individual and cultural-diversity competency: Focus on the therapist. Journal of Clinical Psychology, 60, 755–770.PubMedCrossRefGoogle Scholar
  13. Duckworth, M. P. (2005). Behavioral health policy and eliminating disparities through cultural competency. In N. A. Cummings, W. T. O’Donohue, & M. A. Cucciare (Eds.), Universal Healthcare: Readings for Mental Health Professionals. Reno, NV: Context Press.Google Scholar
  14. Duckworth, M. P., & Iezzi, T. (2005). Recognizing and dealing with cultural influences in psychotherapy. In W. T. O’Donohue (Ed.), Clinical Strategies for Becoming a Master Psychotherapist. Boston, MA: Elsevier.Google Scholar
  15. Eiser, A. R., & Ellis, G. (2007). Cultural competence and the African American experience with healthcare: The case for specific content in cross-cultural education. Academic Medicine, 82, 176–183.PubMedCrossRefGoogle Scholar
  16. Genao, I., Bussey-Jones, J., Brady, D., Branch, W. T., & Corbie-Smith, G. (2003). Building the case of cultural competence. The Academic Journal of the Medical Sciences, 326, 136–140.CrossRefGoogle Scholar
  17. Hays, P. A. (1996). Addressing the complexities of culture and gender in counseling. Journal of Counseling & Development, 74, 332–338.Google Scholar
  18. Kearney L. K., Draper, M., & Barón, A. (2005). Counseling utilization by ethnic minority college students. Cultural Diversity and Ethnic Minority Psychology, 11, 272–85PubMedCrossRefGoogle Scholar
  19. La Roche, M. J., & Maxie, A. (2003). Ten considerations in addressing cultural differences in psychotherapy. Professional Psychology: Research and Practice, 34, 180–186.CrossRefGoogle Scholar
  20. New Freedom Commission on Mental Health (2003). Achieving the promise: Transforming mental health care in America. Washington, DC: Author. Retrieved from
  21. Roysircar, G. (2004). Cultural self-awareness assessment: Practice examples from psychology training. Professional Psychology: Research and Practice, 35, 658–666.CrossRefGoogle Scholar
  22. Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Development of the Multicultural Counseling Inventory: A self-report measure of multicultural competencies. Journal of Counseling Psychology, 41, 137–148.CrossRefGoogle Scholar
  23. Sue, S. (1998). In search of cultural competence in psychotherapy and counseling. American Psychologist, 53, 440–448.PubMedCrossRefGoogle Scholar
  24. Sue, S. (2006). Cultural competency: From philosophy to research and practice. Journal of Community Psychology, 34, 237–245.CrossRefGoogle Scholar
  25. Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal, K. L. et al. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62, 271–286.PubMedCrossRefGoogle Scholar
  26. Tait, R. C., Chibnall, J. T., Andresen, E. M., & Hadler, N. M. (2004). Management of occupational back injuries: Differences among African Americans and Caucasians. Pain, 112, 389–396.PubMedCrossRefGoogle Scholar
  27. Tait, R. C., & Chibnall, J. T. (2005). Racial and ethnic disparities in the evaluation and treatment of pain: psychological perspectives. Professional Psychology: Research and Practice, 36, 595–601.CrossRefGoogle Scholar
  28. Taylor, J. S. (2003). Confronting “culture” in medicine’s culture of no culture. Academic Medicine, 78, 555–559.PubMedCrossRefGoogle Scholar
  29. U.S. Census Bureau. (2001). Profiles of general demographic characteristics 2000: 2000 Census of Population and Housing: United States. Washington, DC: Author. Retrieved from
  30. U.S. Department of Health and Human Services. (2000). Healthy People 2010: Understanding and Improving Health (2nd ed.) Washington, DC: U.S. Government Printing Office. Retrieved from
  31. U.S. Department of Health and Human Services. (2001). Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.Google Scholar
  32. Whitfield, K. E., Weidner, G., Clark, R., & Anderson, N. B. (2002). Sociodemographic diversity and behavioral medicine. Journal of Consulting and Clinical Psychology, 70, 463–481.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Melanie P. Duckworth
    • 1
  • Tony Iezzi
  • Aditi Vijay
  • Erika Gerber
  1. 1.Department of Psychology/MS298University of NevadaRenoUSA

Personalised recommendations