A Culturally Sensitive Approach to Mental and Behavioral Health Care: Defining Culturally Affirming Therapy and Culturally Responsive Care

Thrive • July 6, 2022
By Olga L. Mesina, Ph.D.

Forming a trusting, productive therapeutic relationship requires a clinician who takes a client’s cultural background, perspective, and values into consideration. For those in minority cultures – be it racial, sexual, or gender – seeking mental or behavioral health support can be an incredibly vulnerable experience as it may be challenging to find a therapist who understands their culture. 

One possible solution is working with a culturally sensitive clinician that integrates culturally affirming therapy and culturally responsive care. These therapeutic approaches seek to honor the influence of a person’s culture on their well-being and offer healing strategies for practicing resiliency.

HOW CULTURE INFLUENCES MENTAL AND BEHAVIORAL HEALTH

Culture comprises the core behavior patterns, beliefs, and values within racial, ethnic, religious, and social groups. Often minority cultures, or groups that differ from the dominant populations, face discrimination, oppression, and racism. These experiences can add harmful and traumatic stressors to the lives of those in minority communities, placing them more at risk for mental and behavioral health concerns. 

Some destructive experiences minority groups may face include:

  • Discrimination: Prejudicial and demoralizing treatment based on race, ethnicity, religion, sexual or gender identity, etc. Discrimination may cause a person to hide their true identity in place of one that may be more socially acceptable. 
  • Racial trauma: Mental or emotional harm resulting from living within a racist system or experiencing events of racism, which can result in post-traumatic stress disorder symptoms.
  • Intergenerational and historical trauma: Types of trauma that cause biological, social, mental, and emotional reverberations throughout lineages. 
    • Intergenerational trauma: Occurs when the implications of an individual’s trauma, such as sexual assault, are passed down to their children and so on. Although trauma affects individuals at similar rates across cultures, research shows that those in minority communities are less likely to seek treatment for trauma. 
    • Historical trauma: Develops when a community or generation collectively experiences trauma, such as oppression. The trauma can be passed through the generations.  
  • Generational poverty: Describes when poverty persists for two or more generations. This kind of poverty can be a result of trauma, especially trauma brought on by discriminatory treatment.
  • Health disparities : Those in minority cultures may face a lack of access to health resources and care due to public policies, racial biases, and sex and gender affiliation. 

WHAT IS CULTURALLY AFFIRMING THERAPY?

Culturally affirming therapy values and celebrates one’s cultural identity, while also acknowledging how their cultural background influences their mental and behavioral health. 

Elements of culturally affirming therapy include:

  • Self-awareness: Clinicians gain insight into how their own cultural background, personal assumptions, and unconscious biases impact their personal and professional perspectives. 
  • Education: On their own, professionals work to educate themselves on any aspects of their clients’ cultural identities that they may not be informed about.
  • Understanding: Practitioners ask questions about their clients’ cultural backgrounds to explore what role their identities play in their mental and behavioral health.  
  • Affirmation: Providers affirm their client’s identity and encourage them to embrace their authenticity. They never treat their client’s differences as a “problem,” “symptom,” or “condition.”
  • Acknowledgment: Therapists approach treatment with the understanding that marginalized groups face discrimination , racial trauma , intergenerational trauma , historical trauma , generational poverty, and health disparities that can place them more at risk for mental and behavioral health struggles. They acknowledge any oppression that clients describe experiencing. 
  • Humility: Clinicians lead with humility, accepting any client feedback and adjusting as necessary. 

Through culturally affirming therapy, therapists can make their clients feel understood, supported, and safe to honestly express themselves.  

WHAT IS CULTURALLY RESPONSIVE CARE?

Culturally responsive care is an action-oriented approach that can help clients develop strategies for facing struggles relating to their cultural identities, especially if they’re in a marginalized group.

Elements of culturally responsive care include:

  • Identification: Practitioners identify any symptoms possibly brought on by discrimination such as negative self-talk and feelings of hopelessness. 
  • Reframing: Clinicians may help their clients practice resiliency in the face of oppression while encouraging their personal growth and courage. 
  • Guidance: Clients who engage in “mainstream actions” may encounter resistance from others in their same culture. Providers can guide clients in carrying out these social interactions with others in their community.
  • Collaboration: Therapists work alongside their clients to explore ways to make space for necessary social change. 
  • Mindfulness: Providers encourage the practice of mindfulness as a way of coping with social injustices that are out of their clients’ control. 

A culturally responsive care approach can empower individuals in minority communities to discover healing, happiness, and purpose amid unjust and discriminating circumstances. 

CULTURALLY SENSITIVE MENTAL AND BEHAVIORAL HEALTH CARE AT THRIVE

Thrive offers a safe, welcoming, and healing place for individuals of all cultures. In our therapeutic practice, we lead with the awareness that minorities face unfair societal treatment that may make them more vulnerable to mental and behavioral health concerns. We take a culturally sensitive clinical approach, implementing both culturally affirming therapy and culturally responsive care so individuals of all identities can heal and grow confidently and authentically. Reach out to learn more about our therapeutic services .

About the Contributor

Olga L. Mesina, Ph.D. is a National Board Certified Counselor (NBCC) and Certified Rehabilitation Counselor (CRC) in Northern Nevada who consults Thrive Wellness on a part-time basis to provide clinical and community-based guidance in relation to diversity, equity, and inclusion initiatives. She believes that there is a huge need for culturally aware providers and clinicians that work with underrepresented populations in any community, and is passionate about increasing awareness, developing understanding, and promoting professional development within the mental health care space.

As a first-generation Latina, Olga has been inspired to work tirelessly for the success of all students. Her efforts focus on creating new programming and learning opportunities for students with disabilities to pursue their chosen careers and life goals at the community college level. Olga was born in Winnemucca, Nevada, and grew up mainly in Reno, Nevada. She is a single mom of an amazing 11-year-old daughter. Olga has her Ph.D. in Special Education from the University of Nevada, Reno, focusing on transitioning from K-12 to college. She also holds a Master of Arts in Counseling and Educational Psychology from the University of Nevada, Reno, and a Master of Science in Rehabilitation Counseling from Texas Tech Health Sciences Center. She started her career in higher education as a graduate intern in the Undecided Advising office at the University of Nevada, Reno in 2006.

Olga has worked primarily with individuals with disabilities since 2008 when she joined the Bureau of Vocational Rehabilitation as a Vocational Rehabilitation Counselor. She worked with a diverse clientele and became particularly interested in removing barriers for individuals interested in completing higher education in their pathway to attaining employment. She joined TMCC in 2013 as a specialist in the Re-Entry program and in 2014 as a specialist in the Disability Resource Center, working with students with disabilities transitioning from high school to college. She has been working with the TMCC Disability Resource Center since 2014 and loves working with students and staff. [Preferred Pronouns: She/Her/Hers]

Download our free wellness guide.

Discover the power of small, sustainable changes with "How to Thrive: 10 Simple Habits for Healthy Living." This guide offers practical, easy-to-follow habits that promote physical, mental, and emotional well-being.

By Erin McGinty Fort, MS, MHA, CPC, LPC-S, CEDS-C December 18, 2025
Sometimes, people need more support, structure, and monitoring than the typical outpatient setting can provide. When this happens, the treatment team will usually recommend that someone be "stepped up" to a different level of care, or program, that can better meet their needs. I like to think of it as being similar to medication dosages; people need different strengths of medications, or dosages, to get better when they're sick. Stepping someone up to a higher level of care is like increasing the dosage of a medication to match the severity of their symptoms. How Are Higher Levels of Care Different from Standard Outpatient Care? At the core of differentiating higher levels of care from standard outpatient care is the intensity and structure of the treatment. Higher level of care programs tend to offer more days of treatment each week and more hours of treatment per day than in the outpatient setting. Those in higher level of care programs may also meet with their treatment team members more frequently each week. There are more staff present to support someone at or after meals and snacks, or to help those who are having urges to engage in compulsions or other harmful behaviors. Clients in our HLOC programs get access to an assortment of treatment modalities tailored to their individual needs, including personalized therapy sessions, group support, medication management, medical nutrition therapy with a dietitian, and check-ins with our primary care providers. We support clients with personalized treatment plans and regular assessments to monitor and tweak interventions as needed. Higher levels of care also offer increased peer interaction and support. Intensive programs incorporate additional group therapy sessions, which can help those in treatment feel less alone as well as create a greater sense of community. For some people, it can be difficult to devote the time and energy needed to recover while also balancing other responsibilities like school or work. Stepping up to more intensive levels of care allows people to fully dedicate themselves to recovery. As they get better and make progress, a person may be stepped back down to a less intensive level of care to start practicing their recovery in their usual home, school, or work settings while also receiving professional support from their treatment team. What Levels of Care are Available? At Thrive Wellness, we offer four different levels of care to help clients step up (or down) in their treatment when needed: -  Outpatient Treatment - weekly, bi-weekly, or monthly meetings with a therapist, psychiatrist, primary care provider, and/or dietitian. - Intensive Outpatient Program (IOP) - A minimum of three hours per day, three days per week. - Partial Hospitalization Program (PHP) - A minimum of six hours per day, five days per week. - Residential Treatment - Coming soon in 2026, The Greenhouse at Thrive will offer residential treatment for eating disorders, anxiety disorders, and obsessive-compulsive disorder. This level of care offers 24-hour support for those aged 12-24 living in our residential treatment center. How To Decide Which Level of Care is Right for You If you're unsure which option is right for you or your loved one, we offer a free assessment that can be completed with our admissions team. In this initial assessment, we'll gather information from you about what you're struggling with, speak with our team of providers, and then make a recommendation for what level of care we feel is the best fit for you and your needs. If you’re experiencing symptoms of an eating disorder, anxiety disorder, or other behavioral or mental health challenges, don’t hesitate to reach out. To get started with our intake process, give us a call at 775-525-8103 or fill out this form . We can’t wait to help you Thrive.
December 2, 2025
Like the fir tree, a symbol of endurance rooted in hope, our Family Inclusive Recovery (FIR) approach reflects the strength that grows when families face challenges together. At our new residential center “The Greenhouse”, FIR is more than a treatment model, it’s a philosophy of healing that places families at the heart of recovery for adolescents and young adults navigating eating disorders, anxiety disorders, and obsessive-compulsive disorder (OCD). We believe lasting healing doesn’t happen in isolation; it’s built with the support of families through perseverance, hope, and compassionate care. What Is Family Inclusive Recovery (FIR)? Family Intensive Recovery (FIR) is a specialized and immersive approach that actively engages caregivers as central agents in their child’s healing process. Rather than seeing families as contributors to a problem, we view them as essential partners in recovery. Drawing from two evidence-based frameworks, Supportive Parenting for Anxious Childhood Emotions (SPACE) and Family-Based Treatment (FBT), FIR helps families cultivate resilience, confidence, and connection throughout the journey to recovery. Grounded in SPACE and FBT Through the SPACE model, parents learn how to recognize and reduce well-intentioned but unhelpful behaviors known as accommodations that can reinforce anxiety and OCD symptoms. By shifting from rescuing to supporting and challenging, parents develop the confidence to guide their child through discomfort, helping them build distress tolerance and self-trust. Simultaneously, Family-Based Treatment (FBT) empowers families to take an active, compassionate role in their child’s nutritional and emotional recovery. Parents learn how to support weight and nutritional restoration, disrupt the eating disorder’s patterns, and reestablish boundaries that promote health and growing autonomy. Together, these approaches strengthen both the individual and family system, allowing recovery to take root within an environment of empathy and optimism. From Blame to Collaboration A cornerstone of the FIR model is removing blame. At Thrive, parents are not viewed as the cause of their child’s struggles, but rather as key partners in recovery. Treatment focuses on joining forces to create a safe, supportive environment where: Families learn to sit with their child's discomfort alongside them without rushing to fix or control it. Parents practice compassionate firmness, setting boundaries grounded in care and safety. Teens and caregivers rebuild trust through open, honest communication. This collaborative framework helps families reestablish a sense of connection and confidence, fostering long-term resilience and open communication that extends beyond the treatment setting. Why Family Matters in Recovery Recovery from eating disorders, OCD, or anxiety isn’t a one-person job, it requires integrated care including the family. When families learn to navigate challenges together, they can model emotional regulation, reinforce healthy boundaries, and create conditions for sustained recovery. Through FIR, we aim to strengthen attachment bonds, reshape family interactions, and empower every member of the family to grow. The result is not only symptom reduction but also a deeper sense of unity, hope, and shared endurance, just like the steadfast fir tree that stands resilient through every season. Moving Toward Hope Family Inclusive Recovery invites caregivers and loved ones to become active participants in change. It’s a journey of learning, letting go, and leaning into love and acceptance. Together, families and clinicians can cultivate the courage in clients to face uncertainty, and in doing so, help them discover that recovery is not just possible, but enduring. If you’d like to learn more about Family Intensive Recovery at The Greenhouse or how we support families in eating disorder and OCD treatment, reach out to our team today.
November 14, 2025
The Greenhouse at Thrive Wellness A New Chapter of Hope and Healing in Nevada On Friday, November 14 , we gathered with our partners at Molina Healthcare to share an important moment for our community. Together, we celebrated Molina’s generous $50,000 grant , an investment that is helping bring The Greenhouse to life. Their support is not only a financial contribution—it’s a statement of belief in the young people and families of Nevada who deserve access to compassionate, evidence-based mental healthcare close to home. This gathering marked the beginning of something we’ve dreamed about for years: a place designed specifically for adolescents and emerging adults to receive the care, connection, and support they need during some of the most vulnerable moments of their lives. Something New Is Growing In early 2026 , Thrive Wellness will open The Greenhouse , Nevada’s first residential treatment center devoted to adolescents and emerging adults navigating eating disorders, anxiety, and OCD . For too long, families have faced a heartbreaking dilemma—send their child far from home for treatment or go without the specialized care they need. The Greenhouse is our answer to that gap. It will be a place where young people can settle into an environment built for healing, where they are understood, supported, and surrounded by a team that believes in their capacity to recover. The Greenhouse represents a natural extension of our mission. It’s a living expression of our belief that recovery is possible—and that with the right support, families can find their footing again. 
More Posts

Start your healing journey today

NEXT STEPS

Are you ready to find hope? We can't wait to connect you with the care you need. To get started with us, please reach out using the link below.   

Obsessive Compulsive Disorder

Learn more →

Perinatal

Mental Health

Learn more →

Obsessive Compulsive Disorder

Learn more →

Perinatal

Mental Health

Learn more →