Mental Health Providers' Attitudes, Norms, and Beliefs About Cultural Humility in Service Delivery

Cultural humility is an important provider-level strategy for improving engagement and retention in mental health care. Yet, little research has used theoretical frameworks to examine beliefs and intentions to practice with cultural humility among mental health providers. The current study aimed to fill this gap by using the Theory of Planned Behavior (TPB) to qualitatively explore beliefs, norms, and attitudes regarding cultural humility practice among a sample of 16 professional mental health providers. Participants were predominately women (89.5%), with an average age of 38 years old (SD = 7.98). Participants completed a 30- to 60-min online interview. Thematic analysis was used to examine patterns and identify overarching themes within TPB constructs of behavioral, normative, and control beliefs. Themes within behavioral beliefs reflected improved practice, particularly for working with clients from marginalized groups. However, there was uncertainty in navigating cultural humility practice and concerns about potentially altering the client relationship. Referents for normative beliefs were clinical agencies, professional organizations, university training programs, and supervisors and mentors. Within control beliefs, themes for facilitators and barriers centered around lack of support from mental health systems, personal limitations and strengths, and professional development. This study furthers understanding of mental health providers' attitudes and intentions to practice with cultural humility, as well as underscoring the nuances of when and how these practices are used. This research can help to address barriers and promote cultural humility practice among mental health providers across multiple fields.