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Answers to Your Cultural Competence Questions

Trainings, articles, blogs, and diversity dialogues are great ways to increase our knowledge about things pertaining to diversity, but sometimes you have questions that need answering NOW! This section will serve as a resource for those who have questions about cultural issues and want quick answers. “Answers to Your Cultural Competence Questions,” serves as your very own, at your fingertips, cultural and linguistic competence consultation.


This question and answer section was developed based on questions that have been asked several times in trainings, and consultations. In addition, an email was sent to Nassau County service providers and families requesting the types of things practitioners and families want to know.


Please feel free to email Cheryl Williams at Cheryl.Williams@omh.ny.gov if you have a question that you want answered. You will be answered via whatever means you specify (email or phone). Your question and the resulting answer will be included on this webpage. Feel free to check back regularly as new questions and answers will be added periodically.


Click on the question to go directly to the answer:


I’ve heard the terms cultural competence, cultural humility and cultural responsiveness. Are they the same? As in any field or topic of discussion, we have multiple words that mean the same thing with perspectives that vary slightly. That is the case with these three terms. The term cultural competence implies that one is capable of meeting the needs of culturally diverse clients. People sometimes shy away from the use of such a term because it implies that it is a skill that some one has or does not have; that one can actually “arrive,” so to speak. We do not arrive at cultural competence. We become more efficient at our ability to understand the viewpoints of those culturally different from us when we continue to expose ourselves to different cultures, have conversations, regularly engage in dialogues about diversity and increase our knowledge of specific skills. Cultural humility is the understanding that in order to work with individuals who are culturally diverse, we understand that they are the experts on their culture and thought processes. We remain humble by allowing them to help guide us in the process. This does not assume that the practitioner knows nothing, but that each family is unique and in working with them we view them from a strengths perspective; allowing them to also teach us as we work together towards a common aim. Cultural responsiveness, like the term “cultural competence,” promotes an understanding of culture, ethnicity, and language. The difference between the two is that “responsiveness,” does not imply that one can be perfect and have attained all the skills and views needed to work with culturally diverse clients. It assumes one just has the openness to adapt to the cultural needs of those with whom they work.


Are cultural competence trainings the way to ensure that my organization is culturally competent? Cultural Competence is an ongoing developmental process. While Cultural Competence trainings serve as a good means to increase provider knowledge, skills and awareness, it is insufficient in and of itself to make your organization culturally competent. Cultural competence trainings work best when they exist in a complete framework that supports it; such as (but certainly not limited to) the existence of policies that ensure equitable hiring practices, an environment that is welcoming to those of different cultures (e.g. pictures and brochures that have people of different ethnicities or types of families), and/or connections with cultural resources in the community.


Are policies the way to ensure that my organization is culturally competent? The implementation of policies that ensure your staff attends a minimum amount of cultural competence trainings, has regular worker evaluations inclusive of cultural competence (knowledge, skills and awareness), has equitable hiring and recruitment practices, and offers a culturally inclusive environment is a great start towards cultural competence. However, in and of itself this level of intervention is insufficient. Since we are all cultural beings, we are often not aware of our own biases. As such the provision of ongoing cultural competence trainings will serve to help change the mindset, attitudes and behaviors of those who provide services in your organization.


What is my role as administrator in working towards cultural competence? As an administrator, you can work to ensure cultural competence in a variety of ways. However, it is important that you see yourself as part of the change process. It does little good to schedule cultural competence trainings for your staff, if you and other administrators do not attend these trainings. You are a cultural being and as such are also prone to bias. Increasing your knowledge, skills and awareness will help you become better able to scrutinize practices in your organization in order to make sure that bias does not exist. It also supports your role as a leader and change agent. In addition, your presence at these workshops communicates your level of commitment to cultural competence ideals to your staff. There are other means of working towards cultural competence. Your attendance at trainings alone will not do the trick. You can: • Avail yourself of resources on cultural competence • Regularly assess cultural competence on both the practitioner and organizational level • Include items that assess progress towards becoming culturally competent in staff evaluations • Include cultural competence in your strategic plan • Enact policies that make cultural competence a priority • Recruit staff that is representative of the population you serve • Reward & incentivize personal and professional attempts at becoming more culturally competent • Engage your staff in regular discussions about diversity • Consider culture in treatment planning and staff meetings • Form relationships with cultural brokers/liaisons/resources in your community and seek their expertise when in doubt • Evaluate whether or not there are barriers to service provision based on cultural preference for treatment options There are many things that can be done at the level of administration. This list is not exhaustive, but will definitely point you in the right direction.


What is linguistic competence? Linguistic competence is the capacity to communicate effectively. The ability to convey information in a manner easily understood by diverse audiences such as; persons of limited English proficiency, those who have low literacy skills or are not literate at all, individuals with disabilities and/or youth. Unknowingly, we exclude individuals from being able to benefit from the services we provide because we use language that is not understood, and/or is stigmatizing. Being linguistically competent, we are aware of the ways in which language often serves as a barrier and make sure we communicate in ways that are easy to understand by all and aren’t stigmatizing.


What is ethnicity? How is it different from race? Ethnicity and race are often spoken about interchangeably, but they are not the same. Ethnicity refers to one’s ethnic culture; the vast structures of behaviors, ideas, values, habits, rituals, ceremonies and practices common to a particular group of people that provides them with a general design for living and patterns for interpreting reality. Conversely, race is a fictitious construct. There is no biological basis for race. That being said, when we say, “Race,” we typically are identifying people by skin color; black, white, Asian or Indian. Race, or skin color, is not a way to identify ethnicity or culture. One can be a black American or a white American. As well as one can be a black Trinidadian or an Indian Trinidadian; a white Puerto Rican or a black Puerto Rican. The two often intersect.


What are the typical areas in which there will be cross-cultural differences? Kevin Avruch and Peter Black, who primarily work from the business relations’ perspective, outline six fundamental patterns of cross-cultural differences: 1. Communication styles 2. Attitudes towards conflict 3. Approaches to completing tasks 4. Decision making styles 5. Attitudes towards disclosure 6. Approaches to knowing A simple Google search of these authors will yield detailed, insightful information with definitions and examples of what these differences mean as well as what they look like. However, as it pertains to mental health, there will be more differences such as; differences in the ways in which we describe these issues (some cultures have a limited vocabulary for emotion words and the notion of “mental illness,” does not exist), differences in what we think causes these issues (“God must be mad with us,” “She is being punished for her early promiscuity,” etc), differences in the ways we think we should go about solving these problems (individual therapy, medication management, prayer, reiki, chi gong, meditation, etc).


What are the ways that cultural groups will differ in coping style? Collective cultures are more likely to use interdependent coping strategies than individualistic cultures. This may be going to church more, fasting collectively, praying collectively. There may also be reliance on individual, spiritual means; individual fasting, and/or praying, tarot cards, fortune tellers, deep breathing, relaxation, mediation, herbal medicine, etc. Avoidance may also be used. Keeping things to oneself as opposed to burdening the larger group may also be employed. Individualistic cultures, European Americans in particular, are more likely to use professional services such as talk therapy, support groups and medication as mental illness is often understood through the lens of a medical model as opposed to a spiritual model. In addition, minority ethnic groups are more likely to be distrusting of more mainstream American treatment approaches. Age, ethnicity, and geographic area often contribute to the degree to which there will be adherence to cultural ideologies. Based on these differences, when offering treatment, it is important to know that one size does not fit all.


What’s so bad about having people using American means of coping and professional services? Won’t it still help? There is nothing inherently wrong with offering culturally diverse groups services that are often promoted in the United States such as; individual therapy, group therapy, family therapy and self help groups. However, there are some things to consider. Ethnic minority groups are less likely to engage in treatment and/or stay in treatment. This has everything to do with the fact that the services we are offering, and sometimes mandate, are not consistent with the way they traditionally solve their problems. As such it may not be understood or embraced and may do more harm than good. Someone from a collective culture that does not value talking about emotions or telling their family secrets may experience distress or guilt if they decide to disclose things that are considered private. Furthermore, in some cultures there are cultural beliefs that one brings more harm to oneself if they talk about their problems, as it will continue to exist if you acknowledge it. In other groups talking about one’s problem may mean that you think you are more important than the rest of your group. In each of these instances, the individual is more likely to experience distress after treatment. Likewise, if there is no community support to reinforce their new treatment choice and healing practices, it is not likely to be beneficial. In addition, forcing one way of seeing the world and treating problems is an ethnocentric practice; asserting that there is only one right way. Penalizing individuals for not complying with our recommendations, such as saying the individual who does not go to individual therapy is “noncompliant,” is also ethnocentric. If we are seeking to do the most good, we need to find out the way this individual or family see’s their problem, and what are the traditional means by which people in their culture solve their problems and decide on a plan that is suitable to the client, incorporating community resources.


How do I recruit staff that represents the clients I serve? In recruiting staff representative of the community you serve, you would employ common marketing strategies. Post job postings and other such fliers in the areas most frequented by your community of focus. Places such as synagogues, mosques, temples, churches, libraries, delis, health centers, cultural centers, community centers, local newspapers, local radio and television stations. Find local bloggers and ask them to post. Also consider twitter, face book and other social media sites. These fliers should be in both English and the language(s) of your target group. In addition, offer incentives for those who are bilingual. Give special preference to those who live within the community being served.


How do I ensure my family receives services that hold my cultural values in high regard? When you are receiving help from any organization, it is important that you get the best help that you can. Many times there are cultural differences between you and those with whom you are working that make this challenging. It is important for you to voice your concerns. • Make sure to use, “I statements”. “I statements” are a way of talking that doesn’t feel attacking. These statements start with, “I think,” “I feel,” “I want.” So you might say, “I don’t feel as though you are listening to me.” “I don’t feel as though you see my point of view as valid,” or “I understand that’s the way you do it in your family or culture, but that’s not the way we do it in mine.” • If you have addressed the situation and continue to feel as though your point of view is not respected, treated as valid or counted as a strength, it is your right to continue looking around for services that do meet your families needs. Remember, “cultural competence,” on the part of your worker, is mandatory if they are going to help you.


Why does cultural competence matter? Cultural competence is important for a few reasons. The first major reason is because we live in a diverse society. We are diverse with respect to race/ethnicity, social class, gender, sexual orientation, ability, age and religion/spirituality. It should not be assumed that any perspective is better than the other. Each perspective is valid. Despite this truth, those who have traditionally been in positions of power have made rules and policies that are reflective of their cultural points of view, without realizing that they look at the world from a particular cultural lens. This unintentional bias has resulted in such things as the overrepresentation of African American and Hispanic groups in prison, juvenile detention, special education and foster care. In addition, these and other ethnic minority groups have been underrepresented in less punitive, treatment oriented systems such as mental health and inpatient facilities. Give us some examples of cultural mismatches between individuals/families and institutions. Often those who make decisions such as whether or not a CPS case is an incidence of abuse or neglect, are not from the same ethnic or economic group as the family in question. Subsequently we have family court policies that may mandate individual therapy, a treatment option consistent with mainstream American values but inconsistent with the help seeking behaviors or other cultures that may more naturally turn to their spiritual organizations. As it stands, a failure to comply with family court mandates, after many months, may result in termination of parental rights. Is it fair for the family that has cultural values that do not endorse telling outsiders their personal business to be forced to comply with these standards, when they have other, equally valid, and sometimes more helpful options available to them? The mainstream American bias that says individual therapy is the only way to address their problems would say, yes.


In selecting what worker is paired with what client, should I make my selection based on race or ethnicity? It would seem like this is what is implied when we talk about making sure that services are culturally competent, BUT, it has been found that this is not necessarily the most important factor in ensuring that services are culturally and linguistically competent. When matching workers with families, in the absence of language barriers, the two most important considerations are how culturally aware the worker is, and whether or not there is a match between worker and family as it pertains to coping styles. For example, does this worker process things emotionally, “How do you feel?” or is this worker solution oriented in their processing style, “What is your plan from here?” The research says that these considerations may be more important when making cultural matches, than are matches based on ethnicity and race. This is often the case because race and ethnicity don’t always mean that people share the same values. Individual’s can be from the same ethnic or racial group and be from different socio-economic classes or religious groups and have very different values.


We talk about ethnicity a lot, are there other culture or diversity issues we should be aware of? Yes. We have many identities. As such, issues of diversity are relative to these identities. We differ from each other with respect to religious affiliations, race/ethnicity, disability status, sexual orientation, age, and gender, etc. No matter what makes us different, each minority group experiences some distress when those in positions of power and decision-making don’t consider issues of diversity and inclusion.


What does a culturally competent worker look like? A culturally competent practitioner possesses: • KNOWLEDGE: Specific knowledge of cultural groups and an understanding of the role that culture plays in personality formation, manifestation of psychological disorder and help seeking behaviors. • SKILLS: The ability to translate knowledge into practice; specific skills, intervention techniques and strategies both at the individual and institutional levels. • AWARENESS: Awareness of one’s own ethnic and cultural beliefs, biases and stereotypes and how these things may hinder a professional relationship and an understanding of the sociopolitical factors that affect the everyday lives of minority groups.


What does a linguistically competent practitioner look like? The linguistically competent practitioner possesses: • The capacity to communicate effectively. • The ability to convey information in a manner easily understood by diverse audiences such as: persons of limited English proficiency, those who have low literacy skills or are not literate, individuals with disabilities and youth.


How can I make sure I’m not taking knowledge of cultural groups and unintentionally “stereotyping”? According to the American Heritage Dictionary, stereotypes “Are usually oversimplified conceptions, opinions, or beliefs about a person or group.” Stereotypes assume that all people from a particular group conform to an unvarying pattern and lack individuality. This is far from the truth. In fact, research has shown that there are more within group differences than there are between group differences. In one ethnic group you can have individuals raised in different regions, with different economic circumstances, of different genders and of different religions. All of these factors contribute to differences. As such, it is important not to assume one piece of information is representative of the entire group. In contrast to stereotyping, we may generalize without doing harm. Generalizations are a principle, statement, or idea having general application. It means to infer or draw conclusions from many particulars. We can use the basis of what we know about a group to generalize, but never rely on them as hard and fast rules. It is important that information gathering takes place. Drawing your conclusions or generalizations from one source is potentially harmful. Time should be invested in learning many things about the group you want to be able to make a generalization about. We have to make sure that we don’t make the mistake of attributing something to culture that is not relative to culture at all, while simultaneously being mindful not to overlook cultural differences as though it were not an influencing developmental factor. Be open minded and flexible in thought. Question your own stereotypes and biases. Employ the scientific method. Make a hypothesis. Gather information (read, talk to individuals from the particular group of interest, etc.). Test your hypothesis (ask a few people in the group). If your hypothesis seems to be true, continue to refine the ideas by doing more research. If not, start from scratch.

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