A Scoping Review of Client-Reported Therapist Cultural Competence Measures

Abstract The measurement of cultural competence in mental health practice has largely focused on therapist self-report measures. Client-reported measures of therapist cultural competence may inform the provision of client-centered culturally responsive care. This scoping review aimed to describe: (1) the client cultural identities (e.g., race, gender) addressed, (2) the therapist cultural competence domains (i.e., attitudes, knowledge, skills, humility) assessed, and (3) the psychometric properties (i.e., internal reliability, content validity, structural validity, convergent validity) evaluated in client-reported therapist cultural competence measures. A search in four databases yielded 1,884 articles. After screening and review, 63 articles met inclusion criteria and 20 unique measures were identified. Information on the measures was extracted using a codebook. Most measures addressed therapists’ competencies to clients’ general cultural identity ( n = 15, 75%), followed by racial ( n = 7, 35%) and religious ( n = 6, 30%) identity. Fewer measures addressed clients’ gender ( n = 4, 20%), sexual orientation ( n = 3, 15%), and linguistic ability ( n = 2, 10%). Most measures assessed therapists’ cultural skills ( n = 17, 85%), followed by cultural attitudes ( n = 16, 80%), humility ( n = 15, 75%), and knowledge ( n = 10, 50%). Convergent validity ( n = 18, 90%) was the most frequently evaluated psychometric property, followed by internal reliability ( n = 17, 85%), content validity ( n = 15, 75%), and structural validity ( n = 9, 45%). Five (25%) measures earned sufficient ratings across all four psychometric properties. These findings provide a preliminary description of client-reported therapist cultural competence measures. Future research should examine therapists’ competencies on clients’ intersectional cultural identities and should evaluate other psychometric properties for clinical utility.