Skills class 14: Elephant in the therapy room: Conversations about race, ethnicity, and culture in CBT practice

Odusote, Faithful and Kunorubwe, Taf ORCID: https://orcid.org/0000-0002-5624-5299 2025. Skills class 14: Elephant in the therapy room: Conversations about race, ethnicity, and culture in CBT practice. Presented at: European Association for Behavioural and Cognitive Therapies (EABCT) Conference, Glasgow, UK, 05 September 2025.

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Abstract

CBT practice and research increasingly recognise that delivering CBT in a copy-and-paste manner may reduce its accessibility, acceptability, and effectiveness for clients from diverse backgrounds across the UK and Europe (Bennett et al., 2016). Cultural factors significantly shape how psychological distress is understood, which means that a one-size-fits-all approach may not always be appropriate (Naeem et al., 2019). There are implicit cultural assumptions within CBT that require acknowledgement and adaptation (Kunorubwe, 2023), as applying CBT in a rigid, copy-and-paste manner may hinder change, particularly when aspects of therapy conflict with a client’s cultural values or worldview (Jameel et al., 2022). Despite this, many therapists hesitate to engage in discussions about race, ethnicity, religion, and culture (Beck, 2016). Yet, these conversations are crucial. As you read this workshop description, you might wish to pause and reflect: Have you ever hesitated or avoided discussing these topics in therapy? If so, what influenced that decision? Were particular thoughts or emotions at play? Common reasons for avoidance include therapist discomfort (Knox et al., 2003), concerns about appearing intrusive (Dogra et al., 2007), and fear of offending or making clients uncomfortable (Beck, 2016). However, studies indicate that clients often value these conversations, and when handled sensitively, they can strengthen the therapeutic relationship (Fuertes et al., 2002). CBT and LICBT practitioners must consider the client’s cultural identity at every stage—from engagement and assessment to formulation, treatment, and supervision. A key step in addressing this is having open and collaborative conversations with clients about how their cultural background, values, and experiences might shape their understanding of difficulties and preferred ways of working in therapy. By creating a space where clients feel comfortable sharing what is meaningful, therapists can integrate culturally relevant perspectives into assessment and treatment, ensuring therapy feels both effective and personally relevant. This workshop will explore why these conversations are sometimes perceived as "difficult" and provide a foundation for integrating discussions about race, ethnicity, and culture into CBT practice. Implications for CBT Practice in the UK and Europe Through participation in this workshop, CBT and LICBT practitioners will be encouraged to reflect on their clinical work and consider instances where conversations about race, ethnicity, and culture may have been avoided. By exploring the underlying reasons behind this, practitioners can better understand any biases or discomfort they may hold. We emphasise the importance of ongoing reflection, supervision, and self-practice to enhance cultural competence. Acknowledging the cultural assumptions embedded within CBT and actively incorporating clients’ diverse identities into therapy is crucial for ensuring an inclusive and effective practice. This workshop serves as a starting point for this essential work. Key Learning Objectives • Outline the importance of integrating the client's race, ethnicity, and culture in CBT. • Reflect on the topics that practitioners might find challenging or avoid discussing. • Explore the therapist's cognitions linked to why these topics may feel difficult or uncomfortable. • Develop strategies for incorporating discussions about race, ethnicity, and culture into everyday clinical practice.

Item Type:	Conference or Workshop Item (Lecture)
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of Acceptance:	5 September 2025
Last Modified:	16 Sep 2025 13:00
URI:	https://orca.cardiff.ac.uk/id/eprint/180954

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