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Therapists working through telehealth have an ethical and, in some states, legal duty to address cultural competence in healthcare. Awareness and accommodations must be made to address multicultural and diverse telehealth issues. Clinicians who lack the training to work with specific groups of people are required by law to obtain such training in many US states and Canadian provinces. Although not legally required in all states, provinces, or other international locales, having adequate proficiency at working with people from the group being served is ethically required in all cases.
The need for such sensitivity is so great that some state licensing Boards require a minimum of four hours of training dedicated to cultural competence in healthcare. That need is heightened in telehealth, where clinicians can suddenly find themselves in unknown territory with differing religious or cultural norms. Most telehealth providers may want to consider detailed sensitivity training to understand and be appropriately responsive to relevant issues, including the following:
- Language Barriers
- Health Literacy
- Access to Technology
- Digital Literacy
- Trust in Healthcare
- Religious Beliefs
- Socioeconomic Factors
- Privacy Concerns
- Cultural Perceptions of Health and Illness
- Stigma Associated with Certain Conditions
- Beliefs About Medicine
- Time Perception
- Generational Differences
- Gender Roles
- Regional Differences
- Racial Disparities
- Immigration Status
- Patient-Provider Relationship
- Cross-Border Regulations
- Interpretation of Symptoms
- Norms around Disclosure
- Cultural Views on Technology
- Role of Community
- Healthcare Access and Utilization
- Bias and Prejudice
- Internet Connectivity
- Cultural Interpretations of Non-Verbal Cues
- Access to Quiet, Private Spaces
- Traditional Healing Practices
- Availability of Culturally Relevant Resources
- Discrimination and Systemic Inequities
- Telehealth Interface Design
- Family Involvement in Care
- Perceptions of Professionalism
To elaborate on only one of the above…