Culturally sensitive ways of approaching psychotherapy

Psychotherapy is a crucial tool in the psychologists tool box for addressing mental health issues among Indigenous populations. It involves therapeutic conversations and interventions that aim to improve an individual’s well-being. However, for psychotherapy to be effective for Indigenous people, it must be culturally sensitive and adapted to their unique needs and worldviews. In this article, we will explore different types of psychotherapy that are being used or adapted for Indigenous populations.


Culturally Adapted Psychotherapy

This approach modifies existing psychotherapeutic techniques to make them more culturally relevant for Indigenous clients. It involves incorporating cultural values, beliefs, and practices into therapy sessions. For example, a therapist might use storytelling, a traditional practice in many Indigenous cultures, as a therapeutic tool to help clients express their experiences and emotions.


Narrative Therapy:

This therapeutic method focusses on the stories individuals develop in their minds about their life to date. It is particularly relevant for Indigenous populations because it aligns with the oral traditions and storytelling practices prevalent in many Indigenous cultures. This approach helps individuals reframe their life stories in a way that empowers them and promotes healing.


Community-Based Psychotherapy:

Recognizing the importance of community and kinship in Indigenous cultures, this approach involves community participation in the therapeutic process. It can include group therapy sessions, community healing circles, or incorporating community elders or healers into the therapy process. This approach not only addresses the individual’s mental health but also strengthens community bonds and resilience.


Integrative Psychotherapy:

This approach combines Western psychotherapeutic techniques with traditional Indigenous healing practices. For example, a therapist might integrate cognitive-behavioral therapy with traditional practices such as smudging (a cleansing ritual using sacred smoke) or sweat lodge ceremonies. This integration respects and values the client’s cultural background while providing evidence-based therapeutic interventions.


Trauma-Informed Psychotherapy:

Many Indigenous populations have experienced historical and intergenerational trauma. Trauma-informed psychotherapy is an approach that recognizes the widespread impact of trauma and understands the paths to recovery. It involves creating a safe therapeutic environment, empowering the client, and addressing trauma’s impact on the individual’s mental and emotional well-being.



Also known as nature therapy, ecotherapy is based on the idea that connection to the natural world is essential for mental health. This approach can be particularly resonant for Indigenous people, for whom land and nature often hold spiritual and cultural significance. Ecotherapy might involve outdoor sessions, incorporating elements of nature into therapy, or engaging in traditional land-based activities as part of the therapeutic process.


As can be seen here, psychotherapy for Indigenous populations must be culturally sensitive and respectful of their unique experiences and worldviews. By incorporating traditional practices and values into therapy, mental health professionals can provide more effective and meaningful support to Indigenous clients. The types of psychotherapy discussed here represent just a few examples of how therapists are adapting their approaches to meet the needs of Indigenous people. As our understanding of cultural competence in mental health care grows, it is likely that even more innovative and culturally relevant forms of psychotherapy will emerge.


So far we’ve explored classic approaches to therapy with indigenous populations. However, what’s not clear is whether CBT, the mainstay in mainstream populations, can be adapted for use with Aboriginal people.


Cognitive-behavioral therapy (CBT) is one of the most widely taken up approach to psychotherapy in the world. The main focus of CBT is identifying and reworking unhelpful thoughts, beliefs and cooping behaviour with the aim of improving emotional regulation and development of personal coping strategies. However, its effectiveness and cultural sensitivity for Aboriginal people is a topic of ongoing discussion and research.


Cultural Considerations

Aboriginal cultures often emphasize a holistic view of health that encompasses physical, emotional, spiritual, and social well-being. This perspective can differ significantly from the more individualistic focus of CBT. For CBT to be culturally sensitive, it must be adapted to respect and incorporate these holistic values.


Adaptation of CBT

Some therapists have attempted to adapt CBT to be more culturally sensitive for Aboriginal clients. This can include incorporating traditional healing practices, storytelling, and community involvement into the therapy process. By blending Western psychotherapeutic techniques with Aboriginal cultural practices, therapists aim to create a more inclusive and effective therapeutic approach.


Strengths and Limitations

One of the strengths of CBT is its structured and goal-oriented nature, which can provide a clear framework for therapy. However, this structure can also be a limitation if it does not allow for the flexibility needed to incorporate cultural practices and values. Additionally, the emphasis on cognitive processes in CBT may not fully address the emotional and spiritual aspects of healing that are important in Aboriginal cultures.


Research and Evidence

Research on the effectiveness of culturally adapted CBT for Aboriginal people is still limited. Some studies suggest that when CBT is adapted to be culturally sensitive, it can be effective in treating mental health issues among Aboriginal populations. However, more research is needed to fully understand the impact of cultural adaptations and to develop best practices for implementing CBT with Aboriginal clients.


Community Involvement

For CBT to be culturally sensitive, it is crucial to involve Aboriginal communities in the development and adaptation of the therapy. This can include consulting with elders, incorporating traditional knowledge and practices, and ensuring that therapy is delivered in a culturally respectful manner. Community involvement can help ensure that CBT is not only culturally sensitive but also relevant and meaningful to Aboriginal clients.


Whilst CBT has the potential to be a useful therapeutic approach for Aboriginal people, its effectiveness and cultural sensitivity depend on how well it is adapted to meet the unique needs and values of Aboriginal cultures. The incorporation of traditional practices and community involvement can enhance the cultural sensitivity of CBT, making it a more effective tool for addressing mental health issues in Aboriginal populations. However, ongoing research and collaboration with Aboriginal communities are essential to further develop and refine culturally sensitive CBT approaches.

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