Skills Class 17 - Elephant in the Therapy Room: Conversations About Race, Ethnicity, and Culture in CBT Practice

Despite growing recognition that cultural context shapes psychological distress and recovery, many CBT practitioners remain hesitant to engage in conversations about race, ethnicity, and culture within therapy. Avoidance is often driven by therapist discomfort, fear of offending, or uncertainty about how to raise these topics without disrupting the therapeutic process. When left unaddressed, however, such avoidance can limit engagement, weaken formulation, and reduce the effectiveness of CBT for clients from diverse backgrounds.

This Skills Class focuses on developing practical, CBT-consistent skills for initiating and holding conversations about race, ethnicity, and culture within routine clinical practice. Participants will examine the clinical rationale for addressing these factors, grounded in core CBT principles including collaborative empiricism, formulation, and behavioural change. The session will emphasise asking culturally informed questions without placing the burden of education on clients, and embedding cultural context directly into CBT formulations rather than treating it as an external or secondary consideration.

Using applied examples, participants will explore how behavioural experiments can be used not only with clients, but also by therapists, to address avoidance, test assumptions about raising cultural material, and increase confidence in navigating these conversations. Empathy will be framed as an active clinical skill rather than a passive stance, requiring therapists to explore race and cultural context when clinically relevant. The session will examine how to respond to disclosures of marginalisation or discrimination without minimising, premature reframing, or retreating into neutrality.

The Skills Class will also briefly address rupture and repair, acknowledging that mistakes may occur and that ethical practice includes openness to feedback, reflective supervision, and recognition of limits, including when a therapist may not be the right fit for a client. This session is designed for CBT practitioners seeking practical guidance on how to engage with race, ethnicity, and culture in a way that is affirming, clinically grounded, and sustainable within everyday CBT practice.