Attending to divergent beliefs or truths is central to cultural competence, according to an article by Jonathan Yahalom and Alison B. Hamiltonopens in new window in the Journal of Theoretical and Philosophical Psychology. Patients regularly have beliefs about illness that differ from clinical perspectives, and it is important for clinicians to develop skills that promote sensitivity to different beliefs so that they may provide culturally competent care. The authors suggest that philosophical theorizing about the nature of truth can help achieve this goal.
Yahalom and Hamilton describe a refugee mother who contests a diagnosis of clinical depression despite reporting that she has experienced tearfulness for the past 3 months. Although a clinician’s perspective might be that depression is distorting the mother’s assessment of available options, the mother states that her dying by suicide represents her children’s best chance to remain in their host country. The authors observe that a clinician would be correct in diagnosing depression but that asserting this clinical perspective may be at odds with attending to the mother’s cultural experience.
Cultural competence enhances a clinician’s effectiveness in working with people of diverse backgrounds. When clinicians assume that an objective, acultural perspective of psychology exists, a tension arises regarding how to appreciate cultural understandings that differ from clinical knowledge. That tension is between respecting the things patients hold to be true and maintaining the scientific truths established in their own discipline. One perspective seems to challenge the other.
To find a way to guard against imposing one perspective of truth over another, the authors turn to philosophy. Drawing on pragmatic philosophers like William James, Richard Rorty, and others, the authors examine what it means to hold something to be true in clinical settings and to reconsider basic assumptions about truth to improve cultural sensitivity.
In contrast to viewing truth as something objective and factual, pragmatic philosophers help highlight how truth is inextricably cultural. Truths about psychology—held by both patients and providers—can be viewed as perspectives that are pragmatically responsive to a specific cultural environment. Statements about truth can thus be understood to be statements about what is useful for a person. Clinicians are justified in maintaining their truths because they have observed that what they do works. Similarly, patients hold their truths because those truths function in the context of their lived experience.
The authors refer to this approach as “cultural pragmatism,” provide a preliminary model for applying it in clinical settings, and make a broader case for why philosophical theory is important to cultural competence.
Clinicians might implicitly assume that psychological knowledge is factual and objective and transcends cultural experience. But in so doing, they risk prioritizing clinical knowledge over the cultural experience of their patients. In this article, clinicians are invited to reconsider the meaning of “truth” in clinical psychology and refrain from viewing truth as factual and acultural but rather understand it as an expression of cultural identity and experience.
This article is in the Core of Psychology topic area.