# The Cross-Cultural Competencies and Attitudes Toward Ultraorthodox Clients Among Secular Therapists in Israel: An Explanatory Study

## TL;DR

This study explores how secular therapists in Israel feel about working with ultra-orthodox clients and finds a gap between general cultural skills and specific attitudes toward this group.

## Contribution

The study introduces new insights into the relationship between cultural competence and attitudes toward ultra-orthodox clients in Israeli mental health care.

## Key findings

- Secular therapists showed lower competence and mixed attitudes when working with ultra-orthodox clients.
- More experience with ultra-orthodox clients correlated with more positive attitudes.
- Sociopolitical factors negatively influenced therapists' awareness and views of the Haredi community.

## Abstract

Background: To provide effective mental health care across cultural differences, therapists must develop cultural competencies, including an awareness of and sensitivity to diverse backgrounds. In Israel, secular therapists (STs) working with ultra-orthodox (UO), also referred to as Haredi, clients face challenges due to mutual distrust and sociopolitical tensions between the communities. This study aims to assess Israeli STs’ cross-cultural competencies and attitudes toward Haredi clients, examining the association between perceptions and competencies. Methods: The data were collected from an anonymous, self-administered online survey conducted between April and November 2024 among 70 STs in Israel. The study utilized the Cross-Cultural Competence of Healthcare Professionals (CCCHP-27) scale and a self-developed questionnaire assessing STs’ attitudes toward UO clients. The statistical analysis was performed using JASP 0.18.3. Results: While STs exhibited high general cross-cultural competence, their competence in working with Haredi clients was lower and more complex. Therapists with more experience treating UO clients had more positive attitudes toward them, whereas those working in public settings demonstrated lower cultural awareness. Although STs faced cultural and ideological challenges, many expressed openness and professional growth. Notably, while 57.2% felt that working with UO clients improved their skills, only 37.2% recommended it to others. Similarly, while 52.8% enjoyed working with diverse clients, only 27.2% reported enjoying working with UO clients. A negative correlation was found between the emotions about minorities scale and two UO-related subscales, views (ρ = −0.307, p = 0.01) and awareness (ρ = −0.534, p < 0.001), suggesting that local sociopolitical factors influence attitudes toward the Haredi community. Conclusions: This study highlights a gap between STs’ general cross-cultural competencies and their attitudes toward the Haredi population. The findings underscore the need for continued professional training in culturally competent therapy, as personal interactions play a crucial role in bridging societal divides and improving therapeutic relationships.