To encourage culturally competent and linguistically appropriate exchanges and collaborations among families, professionals, students, and communities. These collaborations should foster equitable outcomes for all students and result in the identification and provision of services that are responsive to issues of race, culture, gender, and social and economic status.
The idea of more effective cross-cultural capabilities is captured in many terms similar to cultural competence. Cultural knowledge, cultural awareness, and cultural sensitivity all convey the idea of improving cross-cultural capacity, as illustrated in the following definitions:
Cultural Knowledge: Familiarization with selected cultural characteristics, history, values, belief systems, and behaviors of the members of another ethnic group (Adams, 1995).
Cultural Awareness: developing sensitivity and understanding of another ethnic group. This usually involves internal changes in terms of attitudes and values. Awareness and sensitivity also refer to the qualities of openness and flexibility that people develop in relation to others. Cultural awareness must be supplemented with cultural knowledge(Adams, 1995).
Cultural Sensitivity: Knowing that cultural differences as well as similarities exist, without assigning values, i.e., better or worse, right or wrong, to those cultural differences (National Maternal and Child Health Center on Cultural Competency, 1997).
When considering cultural competence; a concise, practical definition, and some explanation of relevant ideas are needed. Cross, Bazron, Dennis, & Isaacs (1989) explored the concept of cultural competence in the system of care, and developed the definition and framework used here. They are appropriately applied in the school–based programs that will be highlighted later in this discussion.
Cultural competence is defined as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross–cultural situations (Cross et al., 1989; Isaacs & Benjamin, 1991). Operationally defined, cultural competence is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services; thereby producing better outcomes (Davis, 1997 referring to health outcomes). The word culture is used because it implies the integrated patterns of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. The word competence is used because it implies having the capacity to function in a particular way: the capacity to function within the context of culturally integrated patterns of human behavior defined by a group. Being competent in cross–cultural functioning means learning new patterns of behavior and effectively applying them in the appropriate settings. For example, a teacher with a class of African–American children may find that a certain look sufficiently quiets most of the class. Often African–American adults use eye contact and facial expression to discipline their children. However, this is not effective with all African–Americans. Intra–group differences, such as geographic location or socioeconomic background, require practitioners to avoid overgeneralizing. With other students, one might have to use loud demanding tones, quiet non–threatening language, or whatever is appropriate for those students. The unknowing teacher might offend some students and upset others by using the wrong words, tone, or body language. Being culturally competent means having the capacity to function effectively in other cultural contexts.
There are five essential elements that contribute to a system's ability to become more culturally competent. The system should (1) value diversity, (2) have the capacity for cultural self–assessment, (3) be conscious of the "dynamics" inherent when cultures interact, (4) institutionalize cultural knowledge, and (5) develop adaptations to service delivery reflecting an understanding of diversity between and within cultures. Further, these five elements must be manifested in every level of the service delivery system. They should be reflected in attitudes, structures, policies, and services.
Cultural competence is a developmental process that occurs along a continuum. There are six possibilities, starting from one end and building toward the other: 1) cultural destructiveness, 2) cultural incapacity, 3) cultural blindness, 4) cultural pre–competence, 5) cultural competency, and 6) cultural proficiency. It has been suggested that, at best, most human service agencies providing services to children and families fall between the cultural incapacity and cultural blindness on the continuum (Cross et al., 1989). It is very important for agencies to assess where they fall along the continuum. Such an assessment can be useful for further development.
Operationalizing Cultural Competence in School Settings
Prior to the passage of the Education of All Handicapped Children Act of 1975, many children were excluded from public schooling because of behavior problems and a lack of school capacity to address their needs. Under that legislation, now known as the Individuals with Disabilities Education Act (IDEA), the number of students with emotional disturbance included in mainstream education has increased, and continues to grow (Walker, Reavis, Rhode, & Jenson, 1985; Osher & Osher 1995). As this segment of the student population in schools increases it becomes necessary to enhance school–based support for children. In accord with Target 3 of the National Agenda, the Office of Special Education (OSEP), in the U.S. Department of Education, has funded several projects designed to implement culturally competent programs for children and youth with emotional disturbance. Aspects of these cultural competence projects can be examined to illustrate the five elements of cultural competence referenced above. Valuing diversity means accepting and respecting differences. People come from very different backgrounds, and their customs, thoughts, ways of communicating, values, traditions, and institutions vary accordingly. The choices that individuals make are powerfully affected by culture. Cultural experiences influence choices that range from recreational activities to subjects of study. Even how one chooses to define family is determined by culture. In matrilineal societies, a child's maternal uncle plays a central role in care taking. It is common for the father to reside in another domicile, minimizing his role in raising his wife's children. Such a practice may be unfamiliar to people who define family patrilineally. If a child's uncle from a matrilineal culture responded to a call from school, it may be important to know that his culture defines family according to this structure. By accepting this cultural practice, this school can maximize its relationship with the child's family.
Diversity between cultures must be recognized, but also the diversity within them. Individuals are exposed to many different cultures. School, television, books, and other activities present opportunities for multicultural exposure. People generally assume a common culture is shared between members of racial, linguistic, and religious groups. The larger group may share common historical and geographical experiences. However, individuals may share nothing beyond similar physical appearance, language, or spiritual beliefs. Race is a social construct that people use to associate behaviors and attitudes with physical characteristics. Assimilation and acculturation can create kaleidoscopes of subcultures within racial groups. Other factors such as gender, geographic locality, and socioeconomic status can be more powerful than racial factors. A Vietnamese couple may immigrate to America, and raise their children in a suburban area. As a result, the children may identify more with American popular culture than that of their parents. Recognizing intra–cultural differences help illuminate the complexities of diversity that challenge us.
Racial and linguistic minorities are under–represented in educational and mental health occupations, and in some cases disproportionately over–identified as having emotional disturbance. As a result many teachers and counselors come from a different racial and cultural heritage than the children and families they serve. Some OSEP–funded projects organize activities in an attempt to promote better understanding of, and respect for, cultural differences. Families and Schools Together (FAST), an eight–week program which primarily focuses on family empowerment through parent/professional partnerships, organizes weekly dinners with families participating in the program. Each week a different family hosts dinner. Participating families often represent a variety of cultural backgrounds. During these dinners staff facilitate informal activities for families, designed to improve communication between family members. For FAST staff to improve how they communicate with family members, they must respect how that family chooses to communicate. After families graduate from the program, project staff also participate in support group meetings organized by family members. These activities are effective because families and staff are able to respect each other's differences. Community Approaches to Improving Child Success (CAICS), a project based in the Englewood, New Jersey school system, hosts weekend getaways for teachers, primary caretakers, and children in the program. The retreats are designed to begin a process of moving away from blaming others (e.g. the school, "those" teachers, "bad" students) for children's behavior. Participants, including children, are expected to move towards self– accountability. Participants agree that the retreats provide opportunities to value and respect the practices of other cultures. Everyone has an opportunity to develop an appreciation for other peoples' cultural perceptions and the reality of differences. The program stresses the importance of understanding that "different" does not mean "wrong" in cross–cultural interactions. FAST and CAICS project activities foster acceptance of, and respect for, cultural diversity. Through the cultural self–assessment process, school or program staff are better able to see how their actions affect people from other cultures. The most important actions to be conscious of are usually taken for granted. For instance, physical distance during social interactions varies by culture. A teacher may be accustomed to not touching students, but some students could misread such behavior. If physical reinforcement is valued in the students' culture, the teacher's behavior may suggest that the teacher dislikes or is angry with them. Such miscommunication can be avoided through cultural self–assessment and understanding the dynamics of difference. If a person is aware of her or his own cultural behaviors, she or he can learn to modify them when appropriate.
Not only do individuals have a culture to assess, but institutions, such as schools, have and embody a culture as well. For example, in traditional American schools, students are expected to be in a classroom at specified times. When students have problems they are expected to tell a teacher or counselor. Most learning takes place through reading textbooks and note taking, and question asking is encouraged. Teaching is very standardized; lecturing is common. However, all humans do not necessarily learn using this approach. In societies focusing on oral communication, textbooks may not even exist. The concept of an exact time is not used or reinforced in some cultural structures. As a result, students whose cultural heritage includes traditions that differ from the standard American classroom may have difficulties, lose interest, or be incorrectly labeled. Imagine the child accustomed to learning by example forced to learn by rote memorization of facts and theories. Unless that child adapts to this new expected mode of learning, he or she could be considered less than capable by teachers and other students. School culture should be assessed to determine the role it plays in identifying children with problems, and in reinforcing those problems. Knowledge of these influences can help a school, or any organization serving diverse people. The key is developing mechanisms that provide ongoing feedback and suggestions for change.
Developing such mechanisms is a goal of Actualizing Cultural Competence in Educational and Preventative Techniques (ACCEPT), a project in Tucson, Arizona. The program provides consultants to assist the development of cultural self–evaluation capabilities among school staff, project staff, and teachers involved with children in the program. Consultants use surveys and discussions to help teachers and staff become more aware of their own cultural assumptions, and how those assumptions affect others. The consultants assist school–staff in becoming aware of the organizational cultural processes of their school as well. In addition to providing objective information, consultants assist school and project staff in developing tools for self–evaluation. These activities facilitate a continuous process of assessment used to support movement towards cultural competence. Consciousness of the Dynamics of Cultural Interactions
There are many factors that can affect cross–cultural interactions. For example, biases based on historical cultural experiences can explain some current attitudes. Native–Americans and African–Americans, among other groups, have experienced discrimination and unfair treatment from members of the dominant American cultures. These experiences and the mistrust that grew from them is passed down among members of historically oppressed groups, but is often ignored within the dominant culture. Thus there often exists an understandable mistrust towards members of the dominant culture by historically oppressed groups. Similar dynamics should inform a system's policies and practices. For example a social worker may be perceived as the person who breaks up homes. However, if a social worker advocates for strategies to provide support in the home and in the school, she or he has demonstrated the desire to help the child, rather than separate the family. If a school policy is modified according to legitimate concerns expressed by families, they begin to feel valued as partners in the process. The families in the community have helped in policy development, rather than learning about policies developed by others. Changes such as these create new group experiences to convey to members.
Staff and administrators of New Pathway’s, a program in Wichita, Kansas, have responded to negative associations that family members may hold regarding the role of social workers. Social workers are often perceived as the people who remove children and separate families. Many staff members are trained as social workers, but are redefining the social worker role as part of New Pathways. New Pathways focuses on improving family functioning, using an adaptation of the ten–week FAST program to ensure the family role as the primary support mechanism for children. To avoid confirming negative associations regarding social workers, staff have changed how they interact with families. Meetings are held in the family's home rather than in offices. Instead of wearing formal attire, staff dress in a manner perceived by the clients as respectful but unimposing. Rather than completely on their own cultural rules, staff greet and refer to family members according to culturally appropriate titles. Staff also follow the appropriate rules for body language, social distance and eye contact as defined by the family. The project provides translators when family members are not comfortable with English, because staff members do not want to exclude valuable input due to language barriers. By showing this cultural respect, staff and families have developed personal relationships. Being aware of the possible affects of the dynamics of differences allows New Pathway's staff to provide a more productive cross–cultural intervention. Institutionalization of Cultural Knowledge
The knowledge developed regarding culture and cultural dynamics, must be integrated into every facet of a school, program, or agency. Staff must be trained, and effectively utilize the knowledge gained. Administrators should develop policies that are responsive to cultural diversity. Program materials should reflect positive images of all people, and be valid for use with each group. Fully integrated cultural knowledge may affect global changes in human service delivery. For example, educational institutions and accreditation bodies might develop cultural competence standards to ensure teacher and administrator preparation. Then these same professionals could collaborate with families to develop school policies that reinforce culturally familiar values to improve children's behavior. The culturally competent teachers might use these policies to avoid more expensive interventions. When interventions do become necessary, family and community input on cultural issues might be used in determining effective treatment. Institutionalized cultural knowledge can enhance an organization's ability to serve diverse populations.
A program demonstrating institutionalized cultural knowledge is World of Difference. The project serves a high percentage of African–American children in the San Francisco Unified School District. Staff participate in professional development activities conducted by Dr. Wade Nobles, a recognized expert in cross–cultural training. Classrooms are prepared with reading corners consisting of culturally relevant subject matter such as African children's stories, and lessons about influential African–Americans. Morning rituals incorporate aspects of the students’ cultures by utilizing traditional African chant. Academic support employs learning modalities that students are comfortable with, such as oral learning strategies. World of Difference project activities provide for inclusion of food and child care during monthly family–school meetings. Such culturally inclusive practices produce better outcomes for creating a bridge between school, home, and community, and serves as an example of how this program has integrated cultural knowledge in its service delivery system. The fifth element of cultural competence specifically focuses on changing activities to fit cultural norms. Cultural practices can be adapted to develop new tools for treatment. Working with cultural groups that stress veneration of ancestors and invoking a sense of duty in children by illustrating the actions and values of their ancestors provides an example. All children who are members of minority groups that have endured discrimination benefit from the legacy of civil rights activists. If these children's traditional culture also places special emphasis on respect for ancestors, teaching the children of a responsibility to serve human kind similarly can provide a concrete purpose for them. Being motivated by such a purpose may help children to better manage their behavior. Using relevant cultural matter to change services can affect positive change in children's behavior.
A child's cultural background provides traditional values that can be used to create new interventions. For example, because of a need for culturally relevant academic and social–skills learning tools Kakoo ‘o ‘ia Na Lei, a program created for Hawaiian students with emotional disturbance, demonstrated and evaluated use of an elementary school guidance curriculum. The curriculum was locally developed in collaboration with Hawaiian kupuna (respected elders) through an earlier U.S. Department of Education grant. The curriculum is built around stories containing characters that students can relate to. It helps to guide the children through moral problem solving. It illustrates, teaches, and reinforces over 71 specific social, coping, and self management skills through group discussion, small group activities, role playing, Hawaiian–style arts and crafts, and other activities. The curriculum itself is also a treatment for children’s behavioral problems. Pre– and post–test evaluations indicate improvements in clinical symptoms and aggressive and hyperactive behaviors (Smith, Leake, & Kamekona, 1998). The tool invokes traditional cultural norms to develop problem–solving skills, and reduce the children’s behavior problems. Interventions less effective can be replaced with the curriculum, adapting interventions to Hawaiian culture. This example demonstrates how members of a child's family or community can provide invaluable input in the adaptation of services. Collaborative teams using families, communities, educators, mental health practitioners, and others who care about children can collaborate to create service adaptations appropriate for many children. The curriculum developed by one community's kupuna is now in various stages of implementation in 45 schools and agencies throughout the state of Hawaii.
Reforms addressing the needs of children and youth with emotional disturbance have recognized the importance of cultural issues. Developing cultural competence means improving cross–cultural capabilities by adapting services to the cultural context of families and children. This report highlights some of the practices used by OSEP funded cultural competence programs to help others initiate similar activities. While many resources are available to guide that process, developing cultural competence continues to challenge our creativity. However, the dire situation facing our children today, and therefore our nation tomorrow, demands that we embrace this challenge. Written by Mark A. King, Anthony Sims, & David Osher
Defining Cultural Competence
