Leaders encourage cultural understanding, growth

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Just as patients come to Rogers with an array of mental health symptoms, they also have diverse cultural backgrounds and values. Rogers leaders say it’s important to take it all into account.

“A lot of people who work in behavioral health want to support people in the best way they can,” says Dr. Angela M. Orvis, PsyD, Equity, Diversity, and Inclusion (EDI) clinical supervisor. “When we consider this intersectional identity approach, it gives us the best resources and tools to do that in a way that also helps us grow as humans.”

Multicultural orientation

Dr. Ajeng Puspitasari, PhD, LP, ABPP, executive director of clinical services for Rogers’ locations in Appleton, Kenosha, Madison, Sheboygan, and Minnesota, points to a method for navigating patient cultural values and incorporating those into care called multicultural orientation (MCO).

That has three components: cultural humility, cultural opportunity, and cultural comfort.

• Cultural humility: “Cultural humility basically just means really knowing who we are as a human being – our intersectionality and our identities. We are complex as a human being. Then knowing who our patients are as well,” Dr. Puspitasari says. “We all have biases. We all have thought patterns or beliefs about others, and they may not be accurate. It’s about reminding myself to be humble and get to know you as a human.”
• Cultural opportunity: “As therapists, when we sit with patients, sometimes there are cultural moments that if we nurture them and spend time to have a dialogue, it could really enhance their recovery,” Dr. Puspitasari says, adding that you might consider, for example, if a patient doesn’t want to go on a walk as part of their treatment, perhaps it’s because their neighborhood is no longer safe. “That’s called cultural opportunity: the ability to stop and assess and see, OK, is there something that is related to the sociocultural environment of the patient?”
• Cultural comfort: “Cultural comfort is about regulating ourselves,” Dr. Puspitasari says. “Cultural comfort is really learning how we ourselves deal with fragility, with our dysregulation when cultural moments come and somebody else pointed out our biases. It’s thinking about how we can respond effectively.”

A system-level approach

A mindful approach to considering culture can be incorporated at system-level, Dr. Puspitasari says, in areas from policy procedures to pronoun use to conceptualizing gender.

“If we want to transform and advance our cultural approach, we want to do it in a way that is systematic and sustainable long-term,” Dr. Puspitasari says. “We need to be able to put the resources where they need to go, either providing more time, financial incentives, building training and supervision – and all of those require commitment to the work. Having an expert as well, like Dr. Orvis, for example, is important.”

She adds that a successful approach goes beyond trainings for team members and would include data measurement and careful thought about diversity within the workplace.

“Our clinicians’ composition, ideally, would match the composition of our patient population in the United States,” she says. “If we’re thinking about increasing access and treating more diverse patient populations, representation matters.”

Dr. Orvis says integrating cultural responsiveness discussions into team meetings and elevating a voice or perspective that has historically been less heard are a great start.

“Built into all of this is a willingness to self-reflect and grow. Identify our biases and not pretend we don’t have any, and actively work to identify what they are so we can challenge them,” she says. “We’re seeing our patients often in the darkest period of their life. If they’re here for suicidal thoughts or detoxing or a severe eating disorder or OCD, and they walk through the door and we engage in constant microaggressions, they’re not going to want to seek or continue treatment.”

An individual-level approach

Dr. Orvis says individuals can make a difference as well, though it may mean stepping out of their comfort zone.

“People open the door for us to explore cultural concepts and what that means for them,” she says. “If we are uncomfortable, we won’t walk through that door. If our patients repeatedly have that experience of dangling this opportunity and begin ignored, they’re going to stop, and that relationship is going to feel more superficial to them.”

Instead of tiptoeing around cultural discussions, Dr. Orvis and Dr. Puspitasari encourage everyone to take steps to learn and grow – even if there’s a stumble along the way.

“It’s a field that I think elicits a lot of feelings of anxiety or apprehension or fear of doing it wrong,” Dr. Orvis says. “I want to normalize that if you feel that way, don’t let that be the barrier. Do it. If you’re scared, do it anyway.”

“It’s just like learning other skills. Not only do we continue to evolve, sometimes we make mistakes. We are fallible,” Dr. Puspitasari says. “Normalizing that process is important, because if we get to be too perfectionistic about this work, it’s easy for us to give up altogether. We’re all going to stumble and make mistakes, but we can reach out for help. We can learn from each other.”

Exploring other cultures

April is Diversity Month, a time to celebrate our unique backgrounds, cultures, and traditions.

Dr. Orvis says you can do that any day of the year by being intentional about exploring cultures, and the sooner you start, the better.

“You can reflect on what you consume, like media, movies, TV shows, books, and how you can diversify experiences that way,” she says. “Listening to different music, trying different restaurants with different food styles, to break through this echo chamber of sameness we often create for ourselves.”

Since its founding in 2021, Rogers’ dedicated EDI team has helped Rogers to commit to honoring diversity, increasing inclusion, and moving toward equity for both patients and team members.