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My childhood was steeped in cultural contrast. Aged five I moved with my family from a rough part of east London to an affluent area in the north, thanks to my parents’ success in the music business. Our home doubled as a studio and record label office – a melting pot of cultures and sound. My mother came from a tiny village in Japan; my father was raised on a council estate in High Wycombe, England.Ìý

I was always searching for other kids who looked like me, for families that mirrored my own. But we were rare. When friends came over I remember feeling self-conscious – acutely aware that my family looked different. I felt it.Ìý

For most of my life I hadn’t examined my own identity in depth – what it meant to have an English parent, a Japanese parent, to grow up in a predominantly white, middle-class community, always feeling slightly ‘other’ but not knowing how to give this a name.Ìý

Then, at aged 17, I found myself in therapy for the first time. My therapist lived in an affluent area and spoke with a particular British accent that signalled she was of a certain class. I assumed she was in her 50s.Ìý

I deliberately mention my assumption of her race, class and age because I believe these factors shaped my experience of therapy in ways neither of us acknowledged.Ìý

I didn’t feel safe in her presence, and on reflection that was because she reminded me of teachers from school I’d had negative experiences with. Perhaps I felt judged, and this is why I believed she couldn’t help me.Ìý

Each session was uncomfortable and I always left feeling anxious. I eventually swore off therapy altogether, but then somewhere along the way I decided to train to become the therapist I never had – the kind who would see and care for others the way I needed to be seen and cared for.Ìý

Cultural competenceÌý

Until this moment, when my counsellor training began, I hadn’t fully understood what it meant to be impacted by a lack of cultural competence, despite my diverse background. In discovering the personcentred approach I felt aligned. What emerged in particular was my own pursuit of this competence.Ìý

The National Institute for Health and Care Excellence (NICE) defines cultural competence as ‘the ability to understand and respond to a person’s religious, cultural, or language needs and experiences, emphasising equitable and non-discriminatory practice’.¹Ìý

But definitions alone don’t capture the lived reality of being ‘othered’ – of standing at the margins of belonging. While I had seen people treated differently because of their race and class, I hadn’t always known how to articulate my own experience of difference. It was only while training, doing my ‘working with diversity’ module, that I was forced to meet it head-on.Ìý

Therapy Today, June 2025

ConfrontationÌý

We were given a vague idea of what the training would involve but nothing prepared me for the moment our tutor walked into the room and announced: ‘All the black people over there, all the white people over here, and all the mixed people there.’Ìý

I nearly spat out my coffee. Heavy silence followed. Apprehensive and confused, we stumbled into groups. We had been given instructions but they didn’t make sense. What about the minority groups in the majority group? The identity you identify with? How could the broad range of diversity in our class fit into these three groups?Ìý

Some shifted hesitantly from one side to the other, as if searching for direction. The question was unspoken but clear: where do we fit?Ìý

The weeks that followed were volatile, distressing and at times unbearable. The training was optional, but to become culturally competent therapists it was strongly encouraged. I wanted to be competent so I stayed.Ìý

I sat in my discomfort, witnessing the raw emotions of my peers, and confronting my own silence.Ìý

One day my tutor turned to me: ‘Denise, you’ve barely said a word. That’s not like you. What’s going on?’Ìý

I hesitated, then admitted: ‘I feel stuck. Like I have no right to comment.’Ìý

I had spent weeks listening to my black peers express their pain and anger. I felt their words cut deep. The defensiveness and awkwardness among most of the white members in the group made me want to leave. And what could I contribute? What right did I have to speak when my struggle didn’t seem as severe?Ìý

My tutor nodded thoughtfully and said: ‘And that’s the issue. The mixed group doesn’t have a voice.’ This moment was profound. It named something I had felt all my life but had never articulated: the invisibility of being mixed race, and the internal conflict of belonging everywhere and nowhere at once. My awareness shifted.Ìý

In my training group I was consciously and unconsciously avoiding my own discomfort out of fear that acknowledging it would make me appear righteous. I felt my struggle was not equal to the struggle I had observed among some of my peers. How could mine compare? I realised that in the avoidance of facing my own experience of diversity I had been avoiding being with others in theirs: to enquire, to listen and to see. This was transformative.Ìý

CongruenceÌý

The transcultural and transracial dimension present throughout the duration of the course intended to enable us to work with diversity and with clients from all walks of life.Ìý

When training in the NHS, a woman who identified as black, in her late 50s, was assigned to me.* During the first session I sensed that she was curious about me, which is often the case. I assumed she was wondering about my age specifically, and if I could hold her in what she needed to bring. To be congruent in the second session, at the right moment, I smiled and gently said: ‘I’m curious if you’re wondering about my age and experience.’Ìý

Her face lit up and she moved in: ‘Yes, I am, and I’m wondering where you’re from too. Are you South American?’Ìý

I replied: ‘I’m half Japanese, and I’m 31.’ She responded: ‘Wow, that’s lovely. My son is mixed, it’s always so beautiful to see.’Ìý

It was a significant moment because from then on we both relaxed and she began to open up. We spoke about her Jamaican heritage, her biracial son, the invisibility she felt in her age, and the things she missed from her youth.Ìý

Through my congruence, my awareness of how the diversity may be impacting our therapeutic relationship, and my choice to name my sense, we were able to discuss our differences and embrace them. And then the real work began.Ìý

Cultural competence isn’t just theory – it’s lived experience, a willingness to sit with discomfort, to name the unspoken forces at play in human interaction, and to be aware of our own racism, prejudice and bias so we can work with humans congruently.Ìý

My question is: do all therapists recognise the role that cultural competence plays in this work? Are all of us aware of how identity, race and culture – or the failure to acknowledge them – impact the therapeutic space?Ìý

ImplicationsÌý

I think back to my first therapist. Her theories were interesting. Her questions were thought-provoking. But she never made me feel understood. Without that connection, all her expertise felt hollow. I left her sessions feeling more anxious than when I arrived. Worse, I left feeling ‘incurable’. I believe this is why I was drawn to the person-centred approach: it strips away the therapist’s intellectual authority and places the client at the heart of the work. The focus is on presence – empathy, non-judgment, congruence. But even then, a therapist can only guide a client as far as they are willing to go themselves. In a diverse world, therapists of no matter which modality must be willing to sit with their own discomfort before they can truly hold space for others. As therapists our difference is always present in the therapy room – whether in race, gender, class, sexual orientation, age or lived experience. We are not exempt from it.Ìý

Every therapist carries their own biases shaped by their background. The reality remains – counselling, psychotherapy, psychology and psychiatry are still predominantly white, middle-class professions. This presents a barrier for clients who find themselves in minority groups, unless all therapists actively work on cultural competence, or clients can seek therapists who reflect their own identities.Ìý

Cultural competence in therapy requires confronting our own biases. But if we cannot sit with our own discomfort we will struggle to sit with the discomfort of our clients. Sometimes therapists can say they struggle with the word ‘privilege’ where it doesn’t appear to fit their experience of themselves. But if we cannot notice and own the structural advantages we’re given, and how these contribute to systemic oppression, then can we truly say we’re practising in a culturally competent way? As Carl Rogers said: ‘The curious paradox is that when I accept myself just as I am, then I can change.’ As a qualified, practising person-centred therapist of mixed heritage, cultural competence isn’t just an add-on to my practice; it’s intrinsic to it.Ìý

*Identifiable details have been changed.Ìý