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Table 3 Themes regarding culturally competent care
| Theme | Code | Representative quote | Focus group |
|---|---|---|---|
| Definitions | Demographic | The appreciation of people where they come from, their heritage, faith, and belief systems | P, C, A |
| Person-centered | Relating to the patient based on their background, and taking into consideration where they’re from | P, C, A | |
| Clinician techniques | Sharing similarities | Instead of the differences I would focus more on the things that we have in common | P, C, A |
| Respect patient wishes | Well, that’s up to the patient to make that decision | P, A | |
| Explain options to patients | If it doesn’t make it better for you, come back and tell me and we’ll find something different | P, C, A | |
| Patient challenges | Cultural model of mental health | I think that our country is very Spanish, so if you go to the psiquiatra (psychiatrist) or the psicólogo (psychologist) it means you’re crazy | P, C |
| Cultural view of mental illness | I can’t think of any culture where mental illness isn’t a stigma | P, C | |
| Concerns about the clinician’s culture | Some patients reject you for who we are because we are from another culture | C, A | |
| Clinician challenges | Explicit bias | I had one therapist that, I’m mixed, and when I would come to see her, all she wanted to talk about was my culture | P, A |
| Implicit bias | We all have attitudes and beliefs that we come into this practice with that we have to check at the door and be very mindful of | P, A | |
| Institutional challenges | Time | A long time ago you would say 45 minutes, but now it’s half an hour and hopefully they don’t cut that | P, C, A |
| Technological pressures | Before technology, the therapist would look at you. But now they’re typing while you’re talking to them. You don’t feel it | P, C |
