Strategies for Strengthening a Culturally Responsive Mindset

Welcome and Introduction

Good afternoon, everyone, and welcome to today's webinar hosted by Patagonia Health. Today's topic is Strategies for Strengthening a Culturally Responsive Mindset.

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We're excited to hear from today's speaker, Dr. Ryan DeLapp.

Meet the Speaker: Dr. Ryan DeLapp

Dr. Ryan DeLapp is a licensed psychologist, PSIPAC member, co-owner of Empower CBT, and creator of the Racial, Ethnic, and Cultural Healing (REACH) Program. He's widely recognized for his expertise in helping minority individuals heal and navigate cultural structures in their lives. He's authored over 20 publications and conducted over 100 presentations on assessing and treating racial and cultural stress in diverse populations, culminating in his workbook, Empower Yourself Against Racial and Cultural Stress: Using Skills From the REACH Program to Heal, Cope, and Thrive.

Therapy Is a Culture

Thank you for that introduction, and thank you to Patagonia Health for inviting me. Today is an opportunity for us to reflect on ourselves, our stories, and what brings us to this work.

A lot of multicultural training teaches us about other communities: their norms, traditions, and tools for showing respect for someone's background. What's often missing is exploration of what we, as clinicians, bring into the room.

That's why I say therapy is a culture. Whenever we ask someone to step into our office, real or virtual, we're inviting them into a culture, whether it's CBT, psychodynamic work, or mental health intervention broadly, with its own rules, expectations, and ideas about what's healthy and adaptive. The question today is: how do we sensitively create that culture and collaboratively welcome people into it, without forcing assimilation? That starts with being thoughtful about how our own stories shape the culture we create in therapy.

Bringing Your Whole Self: Balancing Expertise and Humility

I'm assuming we're all on this call with real expertise, whether from decades of experience or from being freshly attuned to current literature. That expertise is worth celebrating, but we can't rely on it alone when inviting clients into the culture of therapy.

Normally, humility and openness in this field are about the client. Today, I want to flip that: I'm asking you to reflect on your own identities, strengths, values, and goals, and to consider how those same things could create biases or barriers that make someone feel less safe, comfortable, or seen in your care.

It's natural to feel defensive or dismissive of this kind of reflection, especially if you're experienced, overloaded, or if it stirs up frustration, guilt, or shame. I'd ask you to challenge yourself anyway: find at least one or two growth edges to keep exploring, on your own or with your team. I'll share two exercises at the end that you can use to continue this reflection.

Defining Culturally Responsive Care

“Culturally responsive mindset” is the title, but I want to define culturally responsive care. I use the word “programming” deliberately, it's not just one-on-one or group interactions, but how your website, office, and policies are designed. It's the full picture of care your clients experience.

Culturally responsive care is a framework for respecting the strengths and values within someone's cultural background. This talk won't cover specific strategies or assessment tools; it's about whether you hold an orientation that seeks out, welcomes, and communicates the importance of those strengths and values.

Understanding Cultural Stressors

Culturally responsive care also makes space to discuss cultural stressors, racism, sexism, transphobia, acculturative stress, and even things like relocating to a new region. I've lived in North Carolina, Kentucky, New York, DC, and now Delaware, each with different cultural stressors I've had to adjust to. Culture isn't only about race or gender; it can be about how someone has moved between places. Are we curious enough to explore that with clients who want to talk about it?

Identity and the “Checkbox” Complexity

Each of us carries identity “checkboxes.” I'm a Black male from the South. I endorse some traditions associated with that identity and not others. Culturally responsive care means seeing the individual within their community while also recognizing they may not endorse every element associated with it. My goal today is to explore what we can do, outside the therapy room, to make that kind of respect and acknowledgment more likely.

Barriers to Practicing Culturally Responsive Care

Even with the best intentions, real barriers make this care harder to deliver.

Systemic Factors

Policies, laws, and heavy caseloads (seeing 25–30 clients a week, for example) can restrict how much we can prioritize this kind of care.

Client Factors

High-acuity situations, like suicidality, self-harm, or early psychosis, make it hard to explore background and values while you're focused on stabilization.

Identity Development

Clients, especially younger ones, may not have explored their own identity yet, making it hard for them to engage even when we're open and curious.

Clinician-Client Relationship

Clients may sense a mismatch or lack of shared community with us and withhold trust, no matter how much humility we practice.

Clinician's Emotional Experience

Conversations about culture can bring up our own anxiety, guilt, or shame. Regulating that while staying responsive is on us.

Clinician's Perspective and Intentionality

This work is intentional, it goes beyond what's required or noticed. Without that mindset, it's easy to deprioritize.

Education and Resource Gaps

Sometimes the desire to be culturally responsive outpaces our knowledge or resources. Today covers a few ways to help close that gap.

This isn't an exhaustive list, but treat it as a form of compassion for yourself: these are real, legitimate challenges, and also opportunities to grow more effective in navigating them.

Building a Culturally Responsive Mindset: The Who Am I Exercise

The rest of today centers on ideas to reflect on before, during, and after client interactions, and in everyday life. It's hard to put on a “culturally responsive” hat only at the office; cultivating it daily makes it easier to access in the moment.

Let's start with mindfulness through a brief Who Am I self-reflection. You'll receive full worksheets after today, but for now, grab paper or your phone's notes app and jot down responses as we go.

This exercise began with an eight-year-old client, removed from his parents' care and living with his grandmother, who had developed such a negative self-concept that he'd say, “Dr. Ryan, I wasn't bad this week” instead of just describing his week. We built this exercise with clip art across four areas, identity, interests, strengths, and values, to help him reframe how he saw and presented himself.

I Am (Identity)

Reflect on the complexity of your racial and ethnic identity, and note any better terminology if the standard boxes don't fit. Then consider intersecting identities:

• Age
• Developmental status or disability
• Religion and spirituality
• Socioeconomic status
• Sexual orientation
• Gender identity
• National origin
• Professional or academic identity, roles, and experience

I Like (Interests)

Our offices, metaphors, and conversations often reflect our own interests. Jot down your go-tos for relaxing, engaging, and feeling accomplished.

I Can Do (Strengths)

A strength is an ability or trait you possess and can use meaningfully, not necessarily something award-winning. Identify three or four that show up most in your professional life.

I Care About (Values)

Rate, on a scale of zero to ten, how important different relationships, forms of well-being, and forms of achievement are to you. Our values shape what we communicate as important in our clinical practice.

Reflecting on Your Who Am I Diagram

These questions help elicit how your Who Am I diagram shows up professionally.

Identity Salience

Which parts of your Who Am I diagram feel most salient in your professional role? For me, this shifts depending on the client and the role I'm in.

Your BEAT: Thoughts, Feelings, and Actions

BEAT stands for thoughts, feelings, and actions. What's your BEAT when sitting with a client whose Who Am I diagram is similar to, or different from, your own? Certain symptom profiles may trigger a different BEAT than others. Noticing this matters when discussing culture or background.

Your Journey

Consider your own journey of self-discovery. My life across North Carolina, Kentucky, New York, DC, and Delaware, and the people and history along the way, shapes how I understand culture and background. It's worth reflecting on your own journey before asking clients to share theirs.

Power and Privilege

Our Who Am I diagrams also carry different levels of power, privilege, and marginalization. Early in my career, working in an affluent, predominantly white practice, I noticed my status as an educated, paid provider carried its own power, even as other parts of my identity carried less. A helpful resource for navigating this tension is a short read on responsibly wielding power in therapeutic spaces.

How Your Who Am I Diagram Shows Up With Clients

Therapy is a culture, so how does your Who Am I diagram influence client interactions? Spanierman et al. describe how differences between people can create room for microaggressions, subtle invalidations that feel alienating even when unintended. Differences in values or pace of life are often rooted simply in different Who Am I diagrams, not pathology.

One example: a Black woman on a medical unit was sent for a psychiatric consult after being observed patting her head, when in fact this was a protective, culturally rooted behavior related to preserving her hairstyle, not self-injury. Misreading behavior this way, or taking a “colorblind” approach that ignores culture altogether, can be costly.

What I encourage instead:

• Welcome and embrace
• Challenge and limit pigeonholing
• Explore and invite the invisible
• See beyond the problems and symptoms

A related exercise: think of a client with a different identity than your own and reflect on:

• Client identity interaction: How does their Who Am I diagram compare to yours, and what's your BEAT reaction to the similarities or differences?
• Centralizing your own diagram: Are you tempted to overvalue your own interests (like using sports metaphors) rather than finding ones that fit the client?
• Stereotyping: Are you assuming things about a client based on their community rather than getting to know them individually?

Taking Action Beyond the Therapy Room

Reflect on why this work matters to you personally, then consider how a culturally responsive mindset shows up in action outside sessions.

Personal Education

Attending talks like this one, reading, or taking Harvard's Implicit Association Test (IAT) all count. As a DEI consultant, I've had teams take the IAT on ableism, then discuss the results and translate them into concrete changes in how we accommodate disability in practice.

Talking About Race and Culture

The first time you discuss cultural topics shouldn't be with a client in session. Build community outside the clinical space first. For years, I met monthly with a diverse, cross-country group to discuss cultural topics, sometimes leaving uncomfortable, sometimes affirmed, always building cross-cultural communication skills I could bring back into my practice.

Allyship

Dr. Monica Williams' paper, “Being an Anti-Racist Clinician,” frames allyship as something practiced privately, not for performance or public credit. Done well, it helps you learn what communities actually need and how to support them, informing better clinical recommendations.

Creating Safe Space for Disclosure

Disclosure is a right, not a requirement. A few practices:

• Obtain consent. Invite sharing without demanding it: “I'd love to hear more if you're comfortable, but no pressure if not.”
• Summarize without interpreting. Reflect back a client's own language rather than reframing their experience in clinical terms that may feel judgmental. DBT's GIVE skills (showing interest, leaning in, validating) help here.
• Limit self-disparaging statements. Comments like “I couldn't possibly understand, I'm a white man with all this privilege” put the burden back on the client.
• Limit over-inflating your qualifications. Saying “As a Black male, I get it” flattens someone's individual experience into a group assumption.

Openness to Feedback

Hold both “I'm trying my best” and “I can do better” at once. When feedback comes, accept it, understand its intent and impact, and respond, even while managing your own anger, defensiveness, or shame. Practicing this in personal relationships first can make it easier to receive feedback professionally with less defensiveness.

Grounding Your Approach in Theory: The REACH Program

A culturally responsive mindset should be rooted in theory and clear intent, not just instinct. That's what led me to build the REACH program: rather than relying on what felt right with teenage clients navigating racial and cultural stress, I studied the research on how these stressors affect identity, agency, and control, and organized it into a flowchart clinicians could use with intention.

Key Takeaways

• Do the prep work.
• Practice mindful reflection on your story and how it interacts with your clients' stories.
• Think carefully, individually and with your team, about how to create safe spaces for disclosure.

Your slides include breakout materials, the Who Am I diagram, a link to my book, and my contact information if you'd like to continue the conversation.

Q&A Session

Using the Who Am I Exercise with Teens

Lily's question: How would you use this with teens' identity development?

I introduce the Who Am I exercise early in treatment, being clear that teens control what they share. Afterward, I ask reflection questions like: When did you start identifying with these markers, and who around you shares them? Do your interests match what's expected of you? Who are your strength role models? Do any of your values conflict with your family, peers, or school?

Navigating Cultural Assumptions in Public Health Practice

Claudia's question: A nutritionist said, “I don't give recommendations about tortillas because my family doesn't eat that kind of food.” What should my action be as a public health professional?

Ask the presenter for context on their reasoning and its impact. If it seems limiting, raise that concern directly, and be clear with others about where you stand. This kind of allyship also builds your own empathy for how it feels to need to self-advocate.

Closing Remarks

Thank you again, Dr. DeLapp, for your presentation. If you're new to Patagonia Health, we're an integrated EHR, practice management, and billing solution serving public health and behavioral health organizations. Learn more at patagoniahealth.com. Registered attendees will receive the slides and self-reflection worksheet by email early next week. Have a great day and weekend, everyone.