Cultural Reciprocity with Families

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Cultural Reciprocity with Families
Presented by Diana MTK Autin, Executive
Co-Director Statewide Parent Advocacy Network
(SPAN) Home to NJs PTI, F2F, FV, FFCMH,
P2P National Field Co-Coordinator, National
Family Voices Board member, National FFCMH

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FOCUS OF OUR TIME TOGETHER Families who have
children with mental health, emotional, and/or
behavioral needs reflect the full range of
families in our nation, from race, ethnicity, and
language, to socio-economic status, family
composition, sexual orientation, marital status,
religion, geography, and many more
characteristics.  Culture is not just the overt
aspects of differences in people that are easily
recognizable, such as the difference in the color
skin, dress, food preferences, accent, etc., but
the more subtle aspects that we often take for
granted in our own cultures and the deep-seated
values that underlie our attitudes and behaviors.
This interactive workshop provides strategies and
tools for PSPs to engage and support families
using "cultural reciprocity," and to assist
families from diverse backgrounds to acquire
"cultural capital" about systems of care to
enable them to make more informed choices about
services and partner more effectively with
providers.

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CULTURAL RECIPROCITY A process, not an
outcomeDo unto others as they would have you do
unto them. Cultural reciprocity is about
relationshipslearning about the other, sharing
about oneself You can only practice cultural
reciprocity if you listen with the heartfor the
heartand share your heart

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The Cultural Iceberg
E
Dress - Food Games - Music Fine Arts - Literature
Surface
Deep
Feelings about recognition
Personal space
Status / class
Concept of time
VALUES
Facial expression
Communication style
BELIEFS
Formality / informality
Expression of emotions
Nature of friendships
ATTITUDES
Leadership style
. . . and much much more . . .
Just as nine-tenths of an iceberg is below the
waterline out of sight, nine-tenths of culture
is below conscious awareness.
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Culture shapes status, relationships and
social behaviors with regard to every aspect of
life -Justice for individual vs. group harmony
-Willingness to question authority People from
various backgrounds communicate and process
information differently -Rational vs.
intuitive -Linear vs. circular -Abstract vs.
concrete -Time-bound vs. not
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MYTHOLOGYCultural differences are
unimportant Thoughts All people should be
treated the same Feelings Pressure Resentment
Behaviors Failure to accommodate differences
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REALITYCultural differences are strengths to
build upon Thoughts Cultural differences are
strengths Feelings Curiosity Interest Appreciatio
n Behaviors Affirm differences Seek learning
opportunities
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What Impacts Relationships?

• Status
• Socially acceptable behavior
• Body Language
• How close we stand to each other
• How we communicate process information
• How we interpret silence
• Comfort level with advocacy
• How we approach resolve conflict

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What Impacts Relationships?

• Parenting roles and functions
• Expectations of children
• Beliefs about appropriate developmental goals
  independence
• Views about needing and accepting help from
  non-family members
• Fears about being judged unfavorably

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Cultural Competence/ Cultural Reciprocity
Definition and Conceptual Framework Requires
that individuals and organizations have a defined
set of values and principles, and demonstrate
behaviors, attitudes, policies, and structures
that enable them to work effectively
cross-culturally.
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Individuals organizations that are culturally
competent/reciprocal have the capacity to (1)
value diversity, (2) conduct self-assessment,
(3) manage the dynamics of difference, (4)
acquire and institutionalize cultural knowledge
and (5) adapt to diversity and the cultural
contexts of the families communities they serve.
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Culturally competent/reciprocal individuals and
organizations design and implement services that
are tailored or matched to the unique needs of
individuals, children, families, organizations
and communities served service options are
driven by the familys preferred choices, not by
culturally blind or culturally free
interventions.
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Cultural competence/reciprocity
considerationsVision/missionPhilosophy/commitme
ntLocation(s)Staff volunteersMaterialsPartne
rsCultural knowledgeCultural linguistic
skills

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Do you have what you need to meet the needs of
the families you serve?
Cultural Competence is a multi-layered,
transcending and transforming concept. It is a
journey, not an outcome. The path to cultural
competency requires ongoing self-assessment
improvement planning. Be true to yourself and
take a look at yourself and your organization(s)
Attitude(s) Knowledge base Skill(s)
Organizational behaviors Policies Location Outr
each Employees Culture
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Practice Service Design Cultural competence
reciprocity is achieved by (a) understanding
oneself, and (b) identifying and understanding
the needs and help-seeking behaviors of diverse
individuals and families.What are some of the
help-seeking behaviors of the diverse families
you serve?
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Know Yourself

• Who am I?
• What am I doing here
• What are my
• Goals, purposes
• Expectations
• Motivations?
• What strengths challenges do I bring?
• How can I best use my skills?
• How can I make space for others?

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Know Yourself

• In my family, children are expected to ___
• I feel like an outsider when _______
• I believe the most important thing in life is
  ______________
• My ethnic or cultural heritage is important to me
  because _____

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Self-Reflection

• Roots, places of origin
• Ethnic group, socio-economic class, religion, age
  group, community
• Social interactions with people from ethnic
  groups, socioeconomic classes, religions, age
  groups or communities different from your own

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Self-Reflection

• Speaking language other than English
• Attitudes of your family of origin on people from
  different backgrounds
• Values, beliefs, cultural messages re
• Family
• Child-rearing
• External relationships
• Community
• Health
• Education

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Traits Needed

• Trust
• Hope
• Shared relationships
• Honesty
• Openness
• Flexibility
• Love

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Trust

• Trust is not automatic it must be earned and it
  can be lost.
• Trust must be two-way those who are not trusted,
  do not trust.
• Trust leads to belief in each other and in a
  cause.
• Be honest about the problems, the barriers, the
  potential negative consequences as well as the
  potential benefit of action

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Trust

• Be in it for the long haul. Dont abandon ship
  after the first disappointment or failure.
• Admit mistakes.
• Ask for help!!!
• LISTEN!!!
• Acknowledge others contributions.

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Honesty

• I dont know.
• I havent had this experience before.
• Im confused.
• I need your help.
• I dont understand.
• I made a mistake.

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Flexibility

• Flexibility means willingness to change behavior
  based on circumstances and need.
• How have people accommodated your needs?

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Listening
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Culturally Responsive Philosophy/ApproachNever
develop a new program, implement a new
initiative, or evaluate effectiveness, without
engaging representatives of the diverse community
you seek to support.Period.
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Locations -Accessible to public
transportation-In communities buildings that
diverse communities consider safe and
friendly (i.e., not places where you have to
show ID or go through scanners)-Easy for diverse
families to find and get to-Build in plans for
your staff to go to families .

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Diverse staffat all levels To be an
authentic bridge to the community, your Board,
staff and leadership must be composed of
authentic diverse voices from top to
bottom. .

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Diverse volunteers Support parents
To reach all communities, your
volunteers/support parents must reflect the
diverse communities you serveTo achieve this
diversity requires TARGETED EFFORTS-Targeted
outreach to potential volunteers support
parents from diverse communities-capacity to do
parent leadership and support parent training in
multiple languages (not just interpreted)-Support
s to sustain diverse volunteers .

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Materials -Translated into multiple
languages (check with communities about whether
translation needed)-Translated at low literacy
levels (pilot/test)-Information written in ways
that take culture into consideration-Pictures
are ethnically diverse and/or targeted to
particular communities-English on one side,
Spanish on the other-Materials for diverse
families, and for organizations serving diverse
families who may not have expertise in CSHCN

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Diverse partnersincluding non-traditional
partners (not just those who focus on families
who have children with special needs)-Immigrant
Community based organizations-Faith-based
organizations-WIC, Head Start, FQHCs,
etc.-Legal Services-NAACP, La Raza, civil
rights groups-Other?Partner with
community-based and immigrant-serving agencies,
asking not what they can do for us, but what we
can do together.

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Cultural knowledge-Values, beliefs practices
within their cultural group-Service delivery
systems they have learned to navigate-Their
history where they have been-Their culture who
they are-Sacred places-Dangerous places-What
is important to them

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Examine cultural values Time

• What does it mean to be on time?
• How do you feel when someone arrives late to a
  meeting? Why?

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Examine cultural values Communication
Verbal communication Rates of speech Voice
modulation Pauses Use of silence Time between
QA What is rude? Polite?

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Examine cultural values Communication

• Nonverbal
• Body language
• Eye contact
• Proximity
• Deference
• Respect

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Cultural Scanning
Is the behavior Innocent? Ignorant? Insensitive?
Racist? How to respond? Do we Know the
person? Value the relationship? Have a history

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Cultural skills-Ongoing professional
development for staff, Board, volunteers
-Effective listening -Cultural reciprocity
-Humility -Respectful communication
-Sharing power leadership

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Quality informationDevelop accurate map of
strengths needs of families from diverse
communities whos important, whats important,
relationships -Formal -InformalKnow how
others have addressed these issues

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Ongoing -Planning -Implementation -Evaluati
on -Revision of plan

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Specific Steps toward cultural competence-Dedica
te resources including time-Conduct Cultural
Linguistic Competence Self-Assessment for Family
Organizations (at least every 3 years)-Conduct
Language Access Self-Assessment Develop Plan
(at least every 3 years with annual review)

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Strengths-Based-Parent leadership development
thru peer-to-peer education, support
empowerment-Parents can be leaders regardless of
their education, literacy level, or current
situation

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Strengths-Based-Build leadership, not
dependence-Measure effectiveness in enhancing
family confidence, competence, attitudes
skills-Ask diverse families to assess our
work

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Engage diverse families at all
levels-Routinely ask, listen to, incorporate
the voices of diverse families in programs
services, policy development -Be ready to
hear what families say -Be ready to follow
where families lead-Provide needed
supportsNothing about me, without me.

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Provide language accessMulti-lingual
staffCommunity partnershipsLanguage
LineWebsite materials translation

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Cultural reciprocity-Develop reciprocal
relationships of trust learning about the other,
sharing about oneself -Ask families what will
work for them-Listening with the heart, for the
heartDo unto others as they would have you do
unto them. Seek first to understand, then to
be understood.

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Flexibility responsiveness-Provide
information training at convenient times
locations, in multiple languages
formats

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Targeted services supports-Target
families from underserved communities for more
intensive supports designed to be flexible
responsive to their specific needs-Policies re
intensive supports

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Cultural mediatorHelp service delivery
systems-Establish maintain trust-Build
meaningful relationships

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Catalyst for changeHelp service delivery
systems-Recognize the barriers for
families-Make changes to address
barriers-Engage families in all
processes

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CommitmentPeople say, what is the
sense of our small effort.They cannot see that
we must lay one brick at a time, take one step at
a time.A pebble cast into a pond causes ripples
that spread in all directions. Each one of our
thoughts, words and deeds is like that.No one
has a right to sit down and feel
hopeless.Theres too much work to do

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Resources to Help Assess Cultural Linguistic
Competence Develop Improvement Plans

• Language Assistance Self-Assessment Planning
  Tool Assessing Access Worksheet
• (Interagency Working Group on LEP, www.lep.gov )
  
• Cultural Linguistic Competence Family
  Organization Self-Assessment (http//www.gucchdge
  orgetown.net/nccc/clcfoa/)
• Parent Center Family-Centered Services
  Non-Profit Management Self-Assessment Tool

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Sample Tools
Sample Language Access Self-Assessments Large
Family Organization Small Family
Organization Sample Language Access Plan Large
Family Organization Small Family Organization

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Other Resources
Working with interpreters tip sheets
(www.parentcenternetwork.org/region1/resources/
other_topics.html) Growing Your Capacity to
Engage Diverse Communities (https//org2.democrac
yinaction.org/o/6739/images/CommunityBrokers_04-27
-2009.pdf) www.HablamosJuntos.org CLAS Standards
Office of Minority Health (www.omhrc.gov/assets/
pdf/checked/finalreport.pdf)

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Questions? Comments?