Clinical supervision is a relationship-based education, considered crucial in providing clinicians with emotional support, skill development and improving client outcomes. Culturally responsive supervision assumes that culture permeates clinical practice and supervision. Culturally responsive supervisors promote the development of cultural competence in supervision, through modelling, reflective discussion and responsivity. Research has demonstrated that greater perceived cultural responsivity in supervision may result in greater satisfaction for supervisees, particularly those from racially or ethnically minoritised (REM) backgrounds. The current study explores supervisee perceptions of culturally responsive supervision and supervisory relationships between different supervisory dyads, comprising supervisees from REM and White backgrounds. This was a cross-sectional design incorporating a between-groups comparison. Trainee and qualified clinical psychologists, counselling psychologists and CBT therapists (n = 222) completed an online survey. Perceptions of cultural responsivity and the supervisory relationship were explored. Participants provided information about their supervisor’s race and ethnicity and their own, and were organised into four supervisory dyads. Participants from REM backgrounds in dyads with White supervisors perceived their supervision as significantly less culturally responsive, with significantly lower quality supervisory relationships. Greater perceived cultural responsivity in supervision significantly predicted better supervisory relationships (regardless of participant cultural background). Findings suggest that culturally responsive supervisory practices may play an important role in developing cultural competence and strengthening the supervisory relationship, particularly in cross-cultural supervisory dyads. Findings present important clinical and theoretical implications.

Cultural competency is a core clinical skill. Yet, psychological therapists may be inadequately trained to deal with the needs of service users from Black, Asian and Minority Ethnic (BAME) backgrounds. This can lead to dissatisfaction with mental health services, disengagement from therapy, and poorer treatment outcomes when compared to the White British population. The aim of this study was to explore whether practitioners working for Improving Access to Psychological Therapies (IAPT) services are culturally competent to deal with the needs of diverse communities. Semi-structured interviews were carried out with a range of practitioners, from early career psychological wellbeing practitioners (PWPs) to senior cognitive behavioural therapists (n=16). Reflexive thematic analysis (RTA) was used to analyse the data, guided by a six-phase process to produce a robust pattern-based analysis. Overall, three themes were generated: (1) encountering cultural dissonance within therapy; (2) challenges in making cultural adaptations to therapy; and (3) identifying cultural competency needs. Out of sixteen participants, only nine therapists received one-day formal training throughout their therapeutic career, whilst seven reported receiving no cultural competence training at all. Overall, it appears that there is an urgent need and desire for therapists to be offered cultural competency training so that they can better serve BAME communities. Clinical implications and future recommendations are made.

The Ukrainian refugee crisis highlights the many issues associated with trauma, distress, mental and physical health, culturally competent assessments, and meaningful support and interventions. This crisis requires international support and a global response, as hosting countries have specific competencies and capacities. The authors hope that the groundswell of international concern over the crisis in Ukraine will lead not only to a comprehensive response to the needs of refugees from that country but also to a recognition of the needs of other asylum seekers and refugees and to our collective moral obligation to address those needs equitably.

Health care and health care systems should be seen and understood in their socio-cultural context. Modern urbanized societies are likely to exhibit health care pluralism, and different therapeutic approaches are available side-by-side. The various models may take their origin in different cultural traditions, but in most societies one type of care is at a given time considered “above” the others. However health care activities in all societies show a degree of interrelation, reflecting societal changes in which normative practices, value systems and structures change over time. In the current Western health systems evidence-based biomedical care is the prevailing system taught to all professionals.

The present paper outlines the prevailing health paradigms, and the advantages and shortcomings of the various approaches and their relation to modern care will be discussed. With increased multicultural backgrounds of patients there is a need for mental health professionals to recognize the existence of traditional approaches and be aware of the parallel systems of care. Competent treatment of such patients requires that mental health professionals are aware of this and exhibit a willingness and ability to bridge between the more traditional and the Western approaches to treatment. The delineations and various aspects of the concept cultural competence and its dimensions will be discussed from a clinical perspective.

Comparative studies of the various Western and the traditional approaches respectively will be reviewed.

Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients.

The stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. To reach these aims, both individual and organizational competence are needed, as well as teaching competence in terms of educational leadership. The WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants list a series of recommendations for policy makers, service providers and clinicians; these are aimed at improving mental health care for immigrants. The authors of this paper would like to underline these recommendations and, focusing on cultural competency and training, believe that they will be of positive value.

This paper is a retrospective exploration of the long-term and deep-reaching impact of an educational aspirations program, Burunga M Gambay (Learning together) (BMG, 2012), on the career pathways and life-long learning of Aboriginal and Torres Strait Islander high school students. The current project, where are the Ghundus (children)? (2017) follows a phenomenological research design by seeking to describe and interpret the long-term effectiveness of BMG through the experiences of the participants and the career pathways they have followed since the program. Qualitative data were collected through semi-structured interviews and analysed iteratively using nVivo 11. The program influenced the participants positively in four major areas: cultural identity, sharing culture, motivation and future aspirations. Notably, all participants completed senior school and added to their qualifications since school and are currently in paid employment. The implications of these findings suggest that future educational aspirations programs be co-constructed with the community to ensure cultural validity and a sense of connectedness. This will, as a result, ensure that the positive effects of such programs are long-lasting and deep-reaching in the educational outcomes for Aboriginal and Torres Strait Islander peoples.

The concept of cultural competence is a multifaceted construct that requires careful consideration as it raises questions as to whose ‘truth’ is being advocated. This paper draws on findings from a qualitative study which used an indigenous methodology of yarning to investigate early childhood educators’ understandings and perspectives of cultural competence. Adopting a poststructuralist approach to grounded theory, data were analysed to identify themes that reflected educators’ understandings and perspectives. This paper presents a snapshot of these themes along with a framework of positioning self in relationship to ways of knowing, being and doing cultural competence. I conclude by suggesting that this framework can provide opportunity for educators to disrupt normalised discourses and re-conceptualise cultural competence.

This is the first research in Singapore into preparation for culturally competent practice in professional clinical psychology training programmes. It analyses experiences of multicultural clinical psychology training and practice and asks how well current programmes are meeting the needs for cultural competency. These questions were explored with qualitative data from interviews about multicultural practice with five students, five academics and five alumni of clinical psychology. Interpretative Phenomenological Analysis revealed four themes: highlighting the culture of clinical psychology, the cultural context of training and practice, cultural competencies, and pathways for developing cultural competency. These outcomes demonstrate that the training programmes are considered valuable for improving psychological service provision in Singapore, although improvements to these programmes are desired for cultural competency development. These findings point to the need for particular competencies to be developed, as well as at directions for further research that may benefit clinical psychology training.