A Primer for the Human Services

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Cultural Diversity: A Primer for the Human Services

By Jerry V. Diller

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What It Means To Be Culturally Competent

Chapter 2

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Significant increase in non-white populations, and significant decline in the relative percentage of whites

Trend is referred to as the “diversification” of America (Atkinson, Morten, and Sue, 1993)

Changing Population Demographics in U.S.

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Projections indicate that by 2050, the U.S. will have a “majority minority”, meaning non-Hispanic whites will make up less than 50% of the U.S. population

By 2010, seven states and the District of Columbia already had a “majority minority” population

California, Texas, New York, Florida, Illinois, Hawaii, and New Mexico

Changing Population Demographics in U.S.

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Unprecedented increases in immigration, particularly from South and Central America and Asia

Comparatively higher birthrates within Hispanic (1.7 times that of whites) and Asian populations (3-7 times that of whites, depending on subpopulation)

Factors Leading to Demographic Changes

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Political backlash

Anti-immigrant sentiment and legislation

Push to repeal affirmative action practices

Polarized society

Growth in number of white supremacist, militia, and anti-government groups

Frustration directed at non-white newcomers

Reactions to Changing Demographics in U.S.

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A more culturally diverse client-base

Bilingual and bicultural professionals preferred

A new conceptualization of effective helping, with cultural competence at its center

Implications for Helping Professions

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No name calling, labeling, or blaming one another

Everyone has learned prejudice through society, and now has an opportunity to do something about their prejudicial attitudes

Whatever is said in the classroom is confidential

This will prevent self-censure

Rules for Discussing Race and Ethnicity

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As much as possible, personalize the discussion by speaking in the first person and talking about your personal experiences

Say what you believe, even though it may lead to conflict

Whatever happens is a learning opportunity and can shed light on the dynamics of intergroup conflict

Rules for Discussing Race and Ethnicity

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“Why do so many immigrants to the United States refuse to learn English?”

“I envy people of color for all their culture and togetherness. We tried practicing some Native American ways, but that didn’t seem exactly right. And besides, we were never made to feel very welcome.”

Frequent Concerns of Students

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“I find it very difficult just getting by financially. I don’t see where all this privilege is.”

“I always had a lot of Black and Latino friends and never saw them as different.”

Frequent Concerns of Students

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“If I had a client of color, I’m not sure I would know what to say or do.”

“White people don’t get it. They just don’t want to see, and no class is going to open their eyes. What I’m not willing to do is be a token person of color here.”

Frequent Concerns of Students

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Ethnocentrism: Culturally diverse behavior is understood in terms of comparison to one’s own culture

Ethnorelativism: Cultures are understood within their own context; culturally diverse behavior is not good or bad, only different

Process of becoming culturally competent transforms how people think, and prepares them to work with culturally diverse clients

Cultural Competence and Cognitive Changes

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Self-honesty:

Hiding from our negative feelings about race, ethnicity, and cultural differences keeps us in the dark

It is important to engage critically with the concepts

Supporting the Pursuit of Cultural Competency

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Sustained commitment:

Cultural competence is a developmental process that takes time

There are multiple stages of growth, and this course is just the beginning

Supporting the Pursuit of Cultural Competency

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For use in a system, agency, or group of professionals

Includes common values and assumptions about service delivery for clients of color

Cross et al. (1989) Model for Cultural Competence

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Some duties of a culturally competent care system include:

Culture is a predominant force that shapes behavior

Family, as defined by the clients’ culture, is an indispensable component of understanding the individual and should be used as the primary point of intervention

Clients may see maintaining the dignity of their people as a way of maintaining their own dignity

Cross et al. (1989) Model for Cultural Competence

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Cultural destructiveness: Agencies whose practices are actively destructive to clients and their culture

Ex.: Historical denial of access to traditional helpers or healers for people of color

Continuum of Cultural Competence in Agencies

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Cultural incapacity: Agencies whose practices are not intentionally destructive, but who demonstrate a lack of experience or capacity to help people of color and their communities

These agencies unintentionally perpetuate societal biases

Ex.: Providers who hold lower expectations for clients of color.

Continuum of Cultural Competence in Agencies

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Cultural blindness: Agencies who attempt to be unbiased by asserting that race and culture make no difference in how service is provided, applying a dominant cultural approach to all

Ex.: Providers who encourage assimilation and/or participate in victim blame.

Continuum of Cultural Competence in Agencies

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Cultural pre-competence: Agencies who recognize problems serving diverse clients, but do not know how to improve despite genuine desire

These agencies tend to focus on single ethnic populations and succumb to tokenism in hiring practices.

Ex.: Agencies that overestimate the cultural competence of one or two providers of color.

Continuum of Cultural Competence in Agencies

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Basic cultural competence: Agencies who understand what skills are required to become culturally competent, and who are honest in their shortcomings

Ex.: Agencies who hire unbiased staff, utilize consultation with communities of color, and assess who they are realistically prepared to serve.

Continuum of Cultural Competence in Agencies

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Cultural proficiency: Agencies who, in addition to demonstrating the characteristics of basic cultural competence, advocate broadly for multiculturalism and participate in related research

Ex.: Agencies who advocate for multiculturalism throughout the healthcare system.

Continuum of Cultural Competence in Agencies

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Awareness and acceptance: Understanding cultural differences (e.g., values, communication style, perceptions of time, community, health) and how they manifest themselves

The acceptance of differing realities without comparison or judgment

Ex.: Movement from accepting to valuing differences and actively using differences in the helping process.

Individual Cultural Competence Skill Areas

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Self-awareness: Understanding the ways one’s own culture impacts behavior, and understanding when and how one’s own cultural boundaries create conflict

This can be particularly difficult for white providers whose sense of culture is absent

Ex.: Knowing when one’s own cultural limits are likely to be pushed, foreseeing and accommodating for possible areas of conflict or tension

Individual Cultural Competence Skill Areas

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Dynamics of difference: Understanding the dynamics between two cultures and when cultural miscommunication is creating conflict

Ex.: Miscommunication because of prior experience with members of the others’ group, and miscommunication because of the political relations between the respective groups.

Individual Cultural Competence Skill Areas

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Knowledge of client’s culture: Familiarization with client’s culture in order to understand his or her behavior in a cultural context

Ex.: Knowledge of meaningful symbols, definitions of health, and the configuration of support systems.

Individual Cultural Competence Skill Areas

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Adaptation of skills: Ability to adjust generic helping practices to accommodate cultural differences

Ex.: Adapting treatment goals, interaction styles, family involvement, time and place of meeting, and treatment topics

Individual Cultural Competence Skill Areas

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Understand own worldviews and how their views are reflected in their work and interactions with racial and ethnic minorities

Understand, appreciate, and share the worldviews of culturally diverse clients

Define goals and use methods consistent with the experiences and cultural values of the clients

Characteristics of Culturally Skilled Counselors

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Counselor awareness of client’s worldview

Attitudes and beliefs

Counselors are aware of their negative and positive emotional reactions to culturally different clients that may negatively impact the counseling relationship

Knowledge

Counselors possess specific knowledge and information about the specific cultural group with which they are working

Three Dimensions of Professional Standards

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Counselor awareness of client’s worldview

Skills

Counselors familiarize themselves with relevant research and the latest findings regarding mental health in various ethnic and racial groups

Three Dimensions of Professional Standards

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Counselor awareness of own cultural values and biases

Attitudes and beliefs

Counselors are aware of how their own cultural background and experiences, attitudes, values, and biases influence psychological processes

Knowledge

Counselors possess knowledge and understanding about how oppression, racism, discrimination, and stereotyping affect them personally and in their work

Three Dimensions of Professional Standards

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Counselor awareness of own cultural values and biases

Skills

Counselors seek out educational, consultative, and training experiences to improve their understanding and effectiveness in working with culturally different populations

Three Dimensions of Professional Standards

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Culturally-appropriate intervention skills

Attitude and beliefs

Counselors respect indigenous helping practices and respect help-giving networks among communities of color

Knowledge

Counselors are aware of institutional barriers that prevent minorities from using mental health services

Three Dimensions of Professional Standards

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Culturally-appropriate intervention skills

Skills

Counselors exercise institutional skills on behalf of their clients, helping clients to determine whether a “problem” stems from racism or bias in others

Three Dimensions of Professional Standards

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Includes three standards which address cultural competency requirements:

Standard 10: Mandates the requirement of curriculum that incorporates knowledge and theories of the interaction of human systems and has an emphasis on context and the role of diversity in meeting human needs.

CSHSE National Standards

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Includes three standards which address cultural competency requirements:

Standard 17: Mandates curriculum that incorporates and promotes an understanding of human services ethnics and their application in practice; promotes the recognition of worth and uniqueness of individuals, including ethnicity, culture, gender, sexual orientation, age, learning style, ability, and socioeconomic status.

CSHSE National Standards

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Includes three standards which address cultural competency requirements:

Standard 18: Mandates that programs provide students experiences and support to develop awareness of their values, and that students demonstrate awareness of diversity.

CSHSE National Standards

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The 2002 Ethics Code of the APA included a section (2.01) which requires acquisition of diversity-related knowledge

APA Professional Standards

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“Guidelines on Multicultural Education, Training, Research, and Organizational Change for Psychologists” (2003) specified a broad range of professional development activities:

Recognition of the psychologist’s own cultural beliefs and attitudes and their influences.

Recognition of the importance of multicultural sensitivity

APA Professional Standards

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“Guidelines on Multicultural Education, Training, Research, and Organizational Change for Psychologists” (2003) specified a broad range of professional development activities:

Inclusion of issues of multiculturalism and diversity in psychological education and research

Support culturally informed policies and practices within organizations and agencies

APA Professional Standards

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Multicultural Ethical Commitment: Includes desire to understand how culture interacts with the resolution of ethical problems, and a commitment to applying APA Ethics Code within a cultural context

Multicultural Ethical Awareness: Includes obtaining requisite knowledge of cultural differences and how they may effect the expression and solution of ethical problems

Fisher’s 3 Related Processes of Multicultural Competence

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Goodness-of-fit ethics and multicultural ethical decision making: Includes understanding that culturally-based ethical decisions are always unique and have multiple variables (e.g., individual differences, environment, goals), requiring each decision-making process to be adjusted in order to ensure fit

Fisher’s 3 Related Processes of Multicultural Competence