Cultural Diversity And Cultural Competency

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Cultural Diversity And Cultural Competency

• The Time Has Come

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• Why Is It So Important?

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Some of the reasonsadd yours

• Diversity in New Jersey You know it
• The challenge of connections
• The role of third places
• Thinking globally, acting locally

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At the Heart of Community

• Hospitality to the Stranger
• Political Necessity
• Moral and Spiritual Imperative

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Hospitality to the Stranger

• Why?
• We are all strangers to someone else.
• The spice of diversity and difference
• Many eyes to see truth

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Differences In The Ways Cultures And Faiths
Answer Fundamental Questions Including

• Who am I? Image of personhood
• Why am I? Purpose in life
• Whose am I? Understandings of family,
  connection, and community
• Why something has happened? E.g., illness,
  accident, injury, disability, tragedy.

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Why? Includes

• What is it? What caused it?
• Whats the purpose of the _______?
• How should the individual respond to it?
• How should others respond to the individual and
  their family?

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Culture

• Culture refers to the shared meanings, values,
  and belief systems that are learned and
  transmitted in society and within social groups
  and influence individuals as well as social
  institutions and organizations in terms of
• customs
• social, political, and other norms and practices
• religious and spiritual traditions
• psychological processes, and
• behavioral norms
• Cultural groups are not necessarily linked by a
  common sense of ancestry.

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In the broadest sense, culture is

• race
• ethnicity
• age
• linguistic grouping
• gender
• sexual orientation
• political affiliation
• Religious beliefs

• spiritual beliefs
• regional affiliation
• ability/disability identification
• socio-economic status
• professional affiliation
• any other characteristic that marks a group
  affiliation.

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Wider Arenas Of How We Look At The World

• Individualism
• Self autonomy
• Self oriented
• Personal Goals
• Unique and Independent
• Individual privacy
• Nuclear family
• Individual rewards
• Competition

• Collectivism
• Group unity/harmony
• Group oriented
• Group goals
• Conforming/interdependent
• Group belongingness
• Extended family
• Equal distribution of rewards
• Cooperation
• From Presentation by Paula Sotnik at AUCD, 2004

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Activity Orientation

• Doing
• Clocks, appointments
• Schedules
• Activity evaluated by product
• Problem solution
• World can be changed

• Being
• Life is relaxed, less hectic
• Activity is not measured by external, observable
  products
• Accept world as is
• (See The Tourist and The Fisherman)

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Think About Practical And Practice Areas This
Impacts

• Interviewing
• Assessing
• End of Life Issues
• Food
• Visiting
• Gender differences

• Rituals of Healing
• Language
• Parenting
• Family
• Decision making
• More?

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So cultural competence is??

• Cultural Competence is defined as
• A set of congruent behaviors, attitudes and
  policies that come together as a system, agency
  or among professionals and enable that system,
  agency or those professionals to work effectively
  in cross-cultural situations. (Cross et.al.)
• The word competence is used because it implies
  building capacity to function effectively in
  cross-cultural encounters

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Cultural Competence

• Focuses on understanding the different
  experiences of members of diverse cultural groups
• Attempts to address the barriers in communication
  across cultures
• Helps develop professionals abilities to work
  effectively with individuals from various
  cultures
• (Pope-Davis Dings, 1995)
• (Center on Capacity Building for Minorities with
  Disabilities, University of Illinois at Chicago)

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Cultural Competence

• Is the result of awareness of our own biases and
  knowledge of the factors that influence cultural
  differences and similarities
• Is a process that requires the development of
  skills, attitudes and behaviors
• (Center on Capacity Building for Minorities with
  Disabilities, University of Illinois at Chicago)

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Or, breaking it down further

• Most definitions have the common elements
• Recognition and adjustment of ones own cultural
  imperatives (cultural awareness plus)
• and
• knowledge and understanding of the culture of the
  patient/consumer (cultural sensitivity plus and
  cultural knowledge)
• with the goal of obtaining
• effectiveness in service delivery in a cross
  cultural encounter. (specific skill/capacity)
• Dr. Anita McClean, Princeton University

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Cultural Competence Is A Continuum And A Journey

• Cultural destructiveness
• Cultural incapacity
• Cultural blindness
• Cultural pre-competence
• Cultural competence
• Cultural proficiency
• - Tawara Goode, National Center on Cultural
  Competency, Georgetown University Child
  Development Center

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Cultural Competence Is A Continuum And A Journey
(cont.)

• Cultural destructiveness is characterized by
  attitudes, policies, structures and practices
  that are destructive to a cultural group in part
  because only one way of being is acknowledged and
  accepted.
• Cultural incapacity is the lack of capacity of
  systems and individuals to respond effectively to
  the needs, interests and preferences of
  linguistically and culturally diverse groups so
  that systematic biases and devaluation mechanisms
  persist.
• Cultural blindness is based on the assumption
  that all people should be treated equally - what
  works with members of one culture should work
  within all other cultures.

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Cultural Competence Is A Continuum And A Journey
(cont.)

• Cultural pre-competence demonstrates an awareness
  of strengths in diversity and the need to respond
  effectively to culturally diverse groups but no
  clear plan for achieving cultural competence
• Cultural competence is characterized by an
  acceptance and respect for difference, actively
  seeking advice and consultation, and a commitment
  and strategic plan for incorporating new
  knowledge and experiences into a wider range of
  practice.
• Cultural proficiency is demonstrated by holding
  cultural differences and diversity in high
  esteem, pro-active behaviors such as culturally
  competent research, innovation and practice and
  the promotion of improved cultural relations
  among diverse groups.

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Building Skills Continuum

• 1. Cultural awareness training
• (See Family Values Exercise)
• 2. Cultural sensitivity training
• 3 Cultural information training
• 4. Cultural competency training

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Strategies And Resources

• Self Assessment
• Organizational Assessments
• Training
• Planning processes that are family/culturally
  centered

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Questions For The Professional To Ask Him/Herself

• Do I respect this familys culture?
• When meeting parents, do I do most of the talking
  or do I listen to their concerns?
• Do I ask parents their opinions or advice?
• Could I learn something from them?
• Do I power dress to meet parents, or do I make
  efforts to minimize social barriers
• - C. Miles, Boggs Center presentation, May 2002

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Questions for Professionals (cont.)

• In what circumstances do parents have a share in
  decision making about what happens in the
  centre/school?
• Would I change my practice on the basis of
  something parents have said?
• Do I believe parents if they describe their child
  behaving in a way that seems very different from
  my knowledge of the child?
• Who sets the agenda for meetings with parents?
• - C. Miles, Boggs Center presentation, May 2002

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Self Assessment Checklists

• National Center on Cultural Competence.
• Self Assessments and Organizational Assessments
• http//www11.georgetown.edu/research/gucchd/nccc/
• foundations/assessment.html
• www.hrsa.gov/culturalcompetence/
• http//rtckids.fmhi.usf.edu/rtcpubs/CulturalCompet
  ence/protocol/CultCompProtocol

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Organizations need to

• Adopt cultural competence as mission and values
• Incorporate cultural knowledge into policy
  making, infrastructure, personnel policies, and
  service provision.
• Design culturally competent practice and service
  delivery mechanisms so that cultural competence
  is an on going part of organizational life
• Require cultural competence from its employees
  and use in performance evaluations along with
  other measures of competency
• Develop non-discriminatory policies and
  implementation mechanisms
• Follow CLAS standards
• Develop engagement with the diverse communities
  that they serve
• Anita McClean, Ph.D.

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Training Resources

• Cultural Brokers Who are they in your community?
• Liaisons
• Cultural Guide
• Mediator
• Catalyst for change
• Consultants/Trainers
• Bridging the Cultural Divide in Health Care
  Settings. Developed for National Health Service
  Corps by
• National Center on Cultural Competence.
• 2004http//gucchd.georgetown.edu/nccc/documents/Cu
  ltural_Broker_Guide_English.pdf

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New Jersey Resources

• New Jersey Statewide Network on Cultural
  Competence
• Website http//www.nj.gov/njsncc
• Organizational survey into a database
• Listserv to share ideas, training, resources,
  questions
• Quarterly forums for networking, planning, and
  training

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Considerations on Using Interpreters

• Working with Interpreters
• Prepare discuss using polite forms,
  non-insulting terms for disabilities (dialect
  differences may be a problem)
• Be aware that the interpreter might not share the
  culture and values of the family because of
  different background in country of origin, or
  different experience of migration show that you
  value cultural difference
• Be aware that the interpreter might speak a
  different dialect from the family
• When using an interpreter, talk directly to the
  parents
• Give the interpreter a chance to explain her role
  and answer the familys questions about herself

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Considerations On Using Interpreters

• Working with Interpreters (contd)
• Do not laugh or joke or use body language with
  the interpreter that excludes the family
• Avoid using jargon and idiomatic expression, or
  content free remarks try to make questions
  specific
• Dont be afraid of silence parents need time to
  respond
• If you need to discuss something with the
  interpreter, explain to the family what you are
  doing
• The interpreter may need to use a lengthy
  explanation for something you conveyed quite
  quickly in English be patient, but then ask her
  to explain exactly to you what she said
• - C. Miles, Boggs Center presentation, May 2002

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Translator Training

• New Jersey International Institute offers
  Translator Training and Cultural Competency
  Training.
• http//www.iinj.org/programs/sections/interpreting
  _translating.html
• Contact Sophia Rossovsky 201-653-3888 ext. 142
  or E-mail srossovsky_at_iinj.org

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Help Build the Network and Share the Knowledge
and Skills

• Join NJ Statewide Network on Cultural Competence
  to share resources, trainings, and strategies.
• Develop trainings at your agencies and
  organizations.
• Invite cultural brokers to help you.

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Cultural Competency Revisited

• Cultural Competency
• or
• Cultural Humility

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For more information

• Rev. Bill Gaventa. Associate Professor
• Department of Pediatrics, RWJMS/UMDNJ
• Director, Community and Congregational Supports
• The Elizabeth M. Boggs Center on Developmental
  Disabilties
• P.O. Box 2688
• New Brunswick, N.J. 08903
• 732-235-9304, email bill.gaventa_at_umdnj.edu
• Website http//rwjms.umdnj.edu/boggscenter/