Do therapists become more culturally humble with experience? Some humility is warranted

Abstract

Research has indicated that clients' perceptions of their therapist's cultural humility are important factors in positive treatment outcomes. However, there is a paucity of research examining whether therapists become more culturally humble over time. In this study, we advance this area of literature by testing whether therapists' cultural humility increases with more clinical experience using data from 1,640 clients seen by 21 therapists in a university counseling center over a 4-year time period. Clients rated their therapist's cultural humility starting at the third session and every four sessions after that. Two-level multilevel models (clients nested within therapists) were used to examine the relationship between therapist experience and client pre-post effect size (Cohen's d), average, and baseline cultural humility ratings. Experience was examined both as chronological time and cumulative clients seen. Results indicated that clients' initial and average ratings of their therapist's cultural humility significantly decreased over time as a function of chronological time and cumulative cases, albeit these effects were small. By contrast, therapists' client pre-post changes in cultural humility did not significantly change over time. Last, the relationship between client average, baseline, and pre-post change in cultural humility did not significantly vary between therapists. Implications for training and clinical practice as well as future research are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).