Culturally Competent Firearm Discussions in Therapy

Therapists can balance ethics and cultural competence in safety discussions.

Reviewed by Gary Drevitch

Key points

• Firearms are an important consideration when safety planning, given their lethality.
• Firearm ownership is a cultural value that psychologists should approach with cultural competence.
• Psychologists can practice cultural competence by increasing relevant knowledge, awareness, and skills.

By Sallie Mack, Ph.D., Danielle Currin, Ph.D., and Alban Foulser, Ph.D., on behalf of the Atlanta Behavioral Health Advocates

As psychologists, we have an ethical duty to promote safety and prevent harm. Given that suicide attempts utilizing firearms are extremely lethal (Cai et al., 2022), we must address firearm safety with our clients. This process can be especially difficult, however, given the divisive nature of our current sociopolitical climate regarding firearms. Providers may find it difficult to align with clients who are reluctant to limit access to their firearms. Additionally, attempts to restrict access to one’s firearms may unintentionally have the opposite effect, as clients who feel pressured by their providers to give up firearms are more likely to become defensive and dishonest (Wolsko et al., 2020). In line with APA’s Resolution on the Secure Storage of Firearms and Lethal Means Safety Strategies to Prevention Suicides (2024), we recommend taking a culturally competent approach. Cultural competency is a lifelong journey of increasing effectiveness in navigating cultural differences via increasing one’s knowledge, awareness, and skills (Sue & Torino, 2005). By conceptualizing firearm ownership as a cultural value tied to identity, we can better understand and align with our clients.

While describing the comprehensive process of safety assessment and planning is outside the scope of this post, below we provide information, prompts for further consideration, and concrete skills for incorporating cultural competence (knowledge, awareness, and skills) into your practices.

Knowledge

Knowledge encompasses the process of learning about another’s culture, values, heritage, and beliefs (Sue & Torino, 2005). Understanding the historical context and importance of firearms can aid in better understanding current gun culture. “Gun culture” was originally coined to represent the social importance of protecting the right to bear arms, in line with values of protecting individual rights and democracy (Hofsradter, 1970; Boine et al., 2020). Today firearm ownership is prominent, with a 2023 Gallup poll finding that 42% of American households have a firearm (Gallup, 2023). Thus, “gun culture” is not a monolith. Firearm subcultures include recreation (e.g., hunting, target shooting), self-protection, and protection of the Second Amendment (Boine et al., 2020). Reasons for purchasing firearms have shifted in recent years, with self-protection becoming a more common motivator (Boine et al., 2020). Subcultures may also vary by state, political identification, occupation or veteran status, and urbanicity. We can work to increase our knowledge of historical and current practices and laws surrounding firearms in the U.S. and in our respective states, as well as the distinct subcultures impacted.

Awareness

Self-awareness includes insight into one’s own cultural identities and values and how they may impact our perspectives (Sue & Torino, 2005). Increasing awareness of our personal beliefs, emotions, reactions, and biases surrounding firearms can help us increase our objectivity in assessing safety issues and align with our clients.

Questions to promote self-awareness:

1. What are my beliefs surrounding firearms?
2. What immediate reactions do I have when someone says they own a firearm?
3. What is my comfort level in discussing firearms? What emotions emerge in these discussions?
4. What previous experiences do I have with firearms? How might these impact my beliefs now?
5. What are my sociopolitical stances regarding firearms (e.g., How do I feel about gun control, or the right to bear arms)?
6. What assumptions might I have about what kind of person owns a firearm?

Other-awareness includes insight and understanding of others’ cultural identities and values. Increasing other-awareness helps us to better navigate differences and collaboratively find common ground. We can combine our self-awareness and knowledge to implement skills that inquire about our clients’ views, values, and emotions associated with firearms. For example, we can explore clients’ histories with firearms, personal and political beliefs, and identities.

Skills

Skills include our behavioral responses tied to our knowledge and awareness that help us work more effectively with clients (Sue & Torino, 2005). In line with APA’s Resolution, we recommend utilizing skills to collaborate with clients to promote lethal means safety strategies (APA, 2024). Combining clients’ values with our professional knowledge of safety risks, we can co-create safety plans that highlight both. Potential skills to incorporate into safety assessment and planning practices include:

• Prioritize building trusting relationships with clients to increase their comfort in disclosing firearms (Marino et al., 2016; Pruitt et al., 2022).
• Utilize nonjudgment and empathy; limit making demands when discussing firearm safety (Betz & Wintemute, 2015; Pruitt et al., 2022).
• Affirm your clients’ right to own firearms and highlight the temporary nature of firearm restrictions in safety planning, as this can increase client willingness to limit access (Marino et al., 2018; Wolkso et al., 2020).
• Find common ground by framing shared goals and values (e.g., increasing safety, improving health, preventing impulsive decisions). Firearm owners often have a strong value of firearm safety and may align more with a generalized safety-focused approach (Wolsko et al., 2020).
• Collaborate to increase time and distance between suicidal urges and accessing firearms. Different levels of access include: temporarily giving up firearms (e.g., asking a trusted and firearm-knowledgeable friend to store it) and safe storage options (e.g., gun safes, lock boxes, cable locks). Discussing multiple safe storage options based on clients’ needs and preferences allows clients to make the most feasible and effective choices (Betz & Wintemute, 2015).

Potential questions:

• What’s your level of willingness to temporarily remove your firearms from your home?
• What concerns do you have about restricting access to your firearms?

Consider having resources (e.g., national and local suicide hotlines), safety plans, and motivational reminders (e.g., family photos) where clients’ firearms are stored, and having gun locks available on-site or provide resources for obtaining secure storage devices. The VA provides one example of a large-scale lethal means safety program, and Project ChildSafe provides information on obtaining free safety kits.

We hope that the approach presented here is a useful tool in navigating emotionally- and politically-charged conversations. We also acknowledge that this process can, at times, require stronger interventions and provider-led decision-making when risk appears imminent. We encourage psychologists to embed cultural competence into the ongoing and dynamic process of safety assessment and planning.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.