How to Put Cultural Competence into Practice

Starting in the late 1980s, the mental health profession responded to the issue of disparity, as does education and other professions and service providers today, , with a new approach to care called cultural competence. Initially defined as a set of congruent behaviors, attitudes and policies that come together in a system, agency or among professionals to enable people to work effectively in cross-cultural situations.

Intended to do the following, cultural competence should:

• Improve access to care
• Build trust and
• Promote engagement and retention in care.

Defined in general terms, cultural competence is:

” …the delivery of services, responsive to the cultural concerns of racial and ethnic minority groups, including their language, history, traditions, beliefs and values.”( U.S. Department of Health and Human Services, 2001)

Mainly, cultural competence refers to guiding principles developed to meet the needs of diverse communities, including ethnic and racial minorities. While, in theort, the need and purpose for cultural competence or proficiency is valid and is critical for equitable The Surgeon General says that evidence-based practices are intended for every consumer regardless of his or her culture. Practices need to be adjusted, however, to make them accessible and effective for cultural groups that differ in language or behavior and traditions. There is no ‘one size fits all’ approach, which means that we must ‘tweak’ our evidence-based practices according to the target audience and the mutually-identified goals. This is where cultural competence comes in.

To deliver culturally competent and evidence-based services, we tailor our interventions to the unique communities we serve-either the practice itself or the context in which the practice is delivered. Since the goal of all programs is to be culturally competent, here are a few strategic steps to take which illustrate that responsiveness.

• Understand the racial, ethnic, and cultural demographics of the populations served
• Become more familiar with one or two of the groups you most commonly encounter
• Create a cultural competence advisory committee consisting of consumers, family and community-based organizations
• Translate your forms and brochures
• Offer to match a practitioner with a consumer/family of similar background
• Use bilingual staff when needed
• Ask your consumers/families about their cultural background and identities
• Incorporate cultural awareness into assessments, interventions
• Tap into natural networks of support, such as extended family and community groups that represent the family’s culture
• Reach out to religious and spiritual organizations to encourage referrals and sources of support
• Train staff in culturally responsiveness in communication skills
• Understand that some behaviors that one culture deems psychopathology, maladaptive or disrespectful are perfectly acceptable in another culture

The word competence implies a set of criteria to evaluate a program, but in this context, it means to tailor care, practices, strategies to different cultures, and places THAT responsibility on the system itself, not the consumer. Therefore every provider or program/school/agency administrator bears the responsibility to make programs accessible, appropriate, appealing and effective for diverse communities served.

Many do it naturally, and deliver culturally competent, evidence based and individually tailored services. Within these environments, there is certain to be what we tend to label, ‘quality’ care, education and services accessed and provided to consumers-children, teens, adults and families. In these cross-systems-strengthened communities, the entire population will tend to be healthier, academic achievement and school performance will likely be less problematic, family and community engagement will likewise rest at higher levels.  Services delivered in the absence of intentionally responsive evidence based practices, procedures, strategies and interventions do not support families, children or their respective community. Why?

When services are delivered within the framework of evidence-based practices which reflect cultural responsiveness and competence, the consumers served by that provider will increase empowerment and enhance life quality. Since cultural competent service delivery is a growing concept, there is no definitive formula or standard set of practices to follow. However, with self-awareness preceding cultural awareness and organizational mission and vision of success accompanying evidence-based practices, respect and appreciation for diversity should optimize service delivery. Ultimately, professionals will    equip all consumers with tools, skills and provide the appropriate supports that will lead to stronger, healthier, and more empowered collective.

Last thought: How will you know which practices apply to different ethnic, racial or cultural groups? The answer is that we won’t know if we don’t try, and we keep trying, tweaking, modifying strategies and adapting interventions- until successful goal attainment.