The Cultural Competence Model

February 10 New Grantee MeetingWashington DC

Andy Hunt, MSWCaptain, US Public Health ServiceSAMHSA Project Officer

Workshop Objectives

1. Understand and define the term “cultural competence” and identify the five elements of the Cultural Competence Model.

2. Increase awareness of one’s own culture and your reactions to cultural differences.

3. Provide common understanding, language and framework for the new CLC Coordinators.

Session Outline

I. Definition of “cultural competence” and exploring concept of “culture”

II. Human needs and culture

III. Discussion on influences of culture in help seeking and service provision

IV. Distinction between “awareness” and “competence”

V. Five Elements of Cultural Competence

Cultural Competence

The state of being capable of functioning effectively in the context of cultural differences.(Cross, et. al)

The majority of the content of this presentation is adapted from Cross, Bazron, Dennis and Isaacs, Toward a Culturally Competent System of Care… 1989.

What is “culture”?

Let’s brainstorm…

Webster’s definition of “culture”

The integrated pattern of human knowledge, belief, and behavior that depends upon man's capacity for learning and transmitting knowledge to succeeding generations

The customary beliefs, social forms, and material traits of a racial, religious, or social group

The set of shared attitudes, values, goals, and practices that characterizes a company or corporation

Maslow’s Hierarchy of Needs

Food

Formal laws/rules

Family & parenting

Housing

Clothing

Social rules

Religious institutionsSocial activities

Spirituality

Stories Art, music, dance

Ceremonies

Human Needs and Culture

Practically speaking, “culture” can be viewed as one group of people’s preferred way of meeting their basic human needs Examples…

This has implications for providing services, especially in system of care where the community is culturally diverse

People tend to have a strong, if unconscious, desire to for their core cultural preferences to meet needs Trust in others from people “like me” Desire for familiarity of surroundings

Potential Areas for a “cultural bump” in Systems of Care

Concepts of mental health, healing, help seeking, and wellness belief systems

Perceptions and explanations of the causes of problems with emotions, mental states, and behavior in children and families

Behavior and coping strategies of family members and their attitudes toward, and expectations of professional helpers

Service delivery structure and process that may not be congruent with the community’s preferences

Other examples…

“Culture is to people as water is to fish”

Please discuss the following statement, and how it relates to working with children and families…

What is the best treatmentfor the common cold?

Do unto others??

Example for discussion: Chicken soup or Vicks VapoRub for your

sick friend? If “programs and services” are set up with

the idea that everyone likes/needs Vicks Vapor Rub when they have a cold… What happens to those who like/need the

chicken soup remedy?

Awareness or Competence?

Awareness having or showing

realization, perception, or knowledge

implies vigilance in observing or alertness in drawing inferences from what one experiences

Competence The state of being

competent having the capacity

to function or develop in a particular way; specifically: having the capacity to respond

Competence a Continuum of ability and skills…

Cultural Competence Continuum

Destructiveness

Incapacity

Blindness

Pre-Competence

Basic Competence

Advanced Competence

© 1989 Cross, et. al

Ongoing Cultural Competence

Cultural competence clearly implies the ability to take action, adapt and function in a different environment

It is a commitment to a developmental process - not a “check box” that you either have or do not have

Elements should be integrated into all aspects of program, policy and services and not viewed as a separate component

Five Elementsof Cultural Competence(at the Individual Level)

1. Awareness and acceptance of difference

2. Awareness of own cultural values

3. Understanding and managing for the “dynamics of difference”

4. Development of cultural knowledge

5. Ability to adapt practice to fit the cultural context of the client/family

Five Elementsof Cultural Competence(at the Organizational Level)

1. Values Diversity

2. Cultural Self Assessment

3. Manages the “dynamics of difference”

4. Institutionalizes cultural knowledge

5. Adaptation to diversity

The “Dynamics of Difference”

What happens when people from two cultures meet…each person interprets the responses of others within the context of his/her own cultural experience. This interaction is affected by differences in: Language and communication style Economic opportunity Family configuration and kinship structures How problems are defined or solved Non-verbal communication Political, historical influences

Examples…

Range of “Dynamics of Difference”

Valuing Diversity Understanding Awareness Idealism (Romanization) Ethnocentrism Prejudice Bigotry Racism Institutional Racism Genocide

Practical Suggestions Know what you don’t know… Be open to learning through the act of

unintentionally offending members of a cultural community different than your own

Find opportunities to get honest feedback by developing relationships with cultural brokers

Observe natural behavior of groups and adapt practices and programs accordingly

Don’t think that you are “done” or have “arrived” at cultural competence

Next Steps

Use this model as a framework Do a self assessment Make a commitment to the process of

enhancing your cultural competence Develop a plan for action Share what you learned Do something different

Thank YouThe majority of the content of this presentation is adapted from:Cross, Bazron, Dennis and Isaacs, Toward a Culturally Competent

System of Care… 1989.

For additional questions about this presentation contact:CAPT Andy Hunt, MSW, LICSWSAMHSA/CMHS1 Choke Cherry Road, Room 6-1054Rockville, MD 20857Phone: 240-276-1926Fax: 240-276-1930Andrew.hunt@samhsa.hhs.gov