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Cross Cultural Skills & Strategies For Helping Professions Spring Academy Prevention & Treatment Exchange 2009 C. Truth Griffeth, LCSW, CDP, NCAC

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Presentation on theme: "Cross Cultural Skills & Strategies For Helping Professions Spring Academy Prevention & Treatment Exchange 2009 C. Truth Griffeth, LCSW, CDP, NCAC"— Presentation transcript:

1 Cross Cultural Skills & Strategies For Helping Professions Spring Academy Prevention & Treatment Exchange 2009 C. Truth Griffeth, LCSW, CDP, NCAC

2 Objectives 1. Gain awareness of own social identity group memberships 2. Examine behavioral consequences and effects of unintentional biases in helping relationships 3. Learn indicators of a professional who is striving for cultural “competency” 4. Review specific clinical considerations for working across difference and practical ways to increase cultural knowledge/skills 5. Share resources for future study

3 Premise: You already have cross-cultural skills You already have cross-cultural skills You have altered or adapted skills in a cultural context You have altered or adapted skills in a cultural context

4 Challenges: Lifetime process: no instant “competence” Lifetime process: no instant “competence” Breadth vs. depth Breadth vs. depth Challenges and risks involved in exploring this topic in mixed groups—may be first time Challenges and risks involved in exploring this topic in mixed groups—may be first time Complex subject with emotionally charged history and meaning Complex subject with emotionally charged history and meaning Language, definitions, meanings Language, definitions, meanings Success will depend on RISK & ACTION… Success will depend on RISK & ACTION…

5 Reflection Exercise: Exploring and learning about each other’s social identities while reflecting on our own experiences…

6 Power Flower

7 Behavioral Consequences of Misunderstanding: Reduced retention/participation in tx Reduced retention/participation in tx Dx: inaccurate, over or both Dx: inaccurate, over or both Staff assignment/time Staff assignment/time Tx planning/research not effective Tx planning/research not effective Utilization/advocacy needs Utilization/advocacy needs Misunderstood family dynamics and cultural beliefs Misunderstood family dynamics and cultural beliefs Delayed care Delayed care Others? Others?

8 “Colorblindness” “Colorblindness” Overconfidence/over identification Overconfidence/over identification Stereotyping/dualistic thinking Stereotyping/dualistic thinking Acculturation and assimilation Acculturation and assimilation Individual vs. collective identity Individual vs. collective identity Who gets “named”: the creation and perpetuation of “otherness” Who gets “named”: the creation and perpetuation of “otherness” Terms like: “Underprivileged” “Underserved” Terms like: “Underprivileged” “Underserved” “Teach me” syndrome: risk, power & invasive questioning “Teach me” syndrome: risk, power & invasive questioning Consider Effects of:

9 Ignorant of—or ignoring— organizational/professional culture and hx Ignorant of—or ignoring— organizational/professional culture and hx “Reverse” discrimination/affirmative action “Reverse” discrimination/affirmative action Collusion/passivity Collusion/passivity “Multiethnic” practice (agenda) “Multiethnic” practice (agenda) Exclusive language and examples in tx Exclusive language and examples in tx “Politically correct” (agenda) “Politically correct” (agenda) Other examples? Other examples?

10 Striving for Competency… (Adapted from “Readings for Diversity and Social Justice” Adams et al, 2000.) Accepts the fact that they have much to learn about others and themselves; takes responsibility for learning how oppression works in everyday life Accepts the fact that they have much to learn about others and themselves; takes responsibility for learning how oppression works in everyday life Feels good about own social group membership; is comfortable and proud of own identity Feels good about own social group membership; is comfortable and proud of own identity Listens to and respects the perspectives and experiences of target group members Listens to and respects the perspectives and experiences of target group members

11 Acknowledges unearned privilege(s) and works to eliminate or change into rights that target group members also enjoy Acknowledges unearned privilege(s) and works to eliminate or change into rights that target group members also enjoy Recognizes that unlearning oppressive beliefs and actions is a lifelong process, not a single event, and welcomes each learning opportunity Recognizes that unlearning oppressive beliefs and actions is a lifelong process, not a single event, and welcomes each learning opportunity Is willing to take risks, try new behaviors, act in spite of own fear and resistance from other agents Is willing to take risks, try new behaviors, act in spite of own fear and resistance from other agents

12 Acts against social injustice, believing it is in her/his own self interest to do so Acts against social injustice, believing it is in her/his own self interest to do so Is committed to taking action against social injustice in own sphere of influence Is committed to taking action against social injustice in own sphere of influence Is willing to make mistakes, learn from them and try again; willing to be confronted about own behavior/attitudes and consider change Is willing to make mistakes, learn from them and try again; willing to be confronted about own behavior/attitudes and consider change Practices self care Practices self care

13 Understands the connections among all forms of social injustice Understands the connections among all forms of social injustice Knows how to cultivate support from other allies Knows how to cultivate support from other allies Has the ability to obtain culturally relevant information in the helping relationship Has the ability to obtain culturally relevant information in the helping relationship Considers: profession, self, agency, client Considers: profession, self, agency, client Understands that helping and healing are culturally specific activities Understands that helping and healing are culturally specific activities

14 Some Clinical Considerations: Some Clinical Considerations: Physical space Physical space Body language/posture/contact Body language/posture/contact Sharing the expert role Sharing the expert role Tone, cadence, volume/address Tone, cadence, volume/address Cultural values: family in healing, time, agendas, etiology Cultural values: family in healing, time, agendas, etiology Motivation for tx Motivation for tx Use of self disclosure Use of self disclosure

15 Clinical Considerations Invasive questions, how helpful clinically? Invasive questions, how helpful clinically? Use of statements as questions— “help me understand….” Use of statements as questions— “help me understand….” Consider translations, interpretations and contexts Consider translations, interpretations and contexts Inclusive language and examples Inclusive language and examples Use of Jargon Use of Jargon Other historical, cultural & ecological factors Other historical, cultural & ecological factors

16 Cultural Assessment Aurthur Kleinman, 1978 Kleinman A, Eisenburg L, Good B, Culture, Illness, and Care. AIM, 1978;88:251. “Every illness is a personal story” What do you call the problem? What do you call the problem? What do you think has caused the problem? What do you think has caused the problem? Why do you think it started when it did? Why do you think it started when it did? What do you think your sickness does to you? How does it work? What do you think your sickness does to you? How does it work? How severe is your sickness? Will it have a short or a long course? How severe is your sickness? Will it have a short or a long course? What are the problems your sickness has caused? What are the problems your sickness has caused? What do you fear the most about your sickness? What do you fear the most about your sickness? What kind of treatment do you think you should receive? What are the most important results you hope to achieve from these treatments? What kind of treatment do you think you should receive? What are the most important results you hope to achieve from these treatments?

17 Learning About One’s Own Culture Historic accounts/Stories Historic accounts/Stories Talk with elders, relatives Talk with elders, relatives Learn history of traditions Learn history of traditions Travel Travel Genealogy Genealogy Go to cultural events Go to cultural events Research Research Museums Museums Teach others Teach others Other? Other?

18 Learning About Other’s Cultures Active listening/Ask Active listening/Ask Attending festivals and cultural events Attending festivals and cultural events Arts: Music/Reading Arts: Music/Reading Immersion Immersion Food Food Travel Travel Community involvement/volunteer Community involvement/volunteer Exchange students Exchange students Other? Other?

19 Ways to Gather Relevant Cultural Information in Clinical Practice Listen to client: including px, non verbal Listen to client: including px, non verbal Ask relevant questions Ask relevant questions Cultural peer review of assessment Cultural peer review of assessment Collaboration with other agencies Collaboration with other agencies Research/internet Research/internet Don’t assume Don’t assume Supervision Supervision Continuing ed/trainings Continuing ed/trainings Assess process Assess process Other? Other?

20 Ways to Change Organizational Culture Education/share knowledge Education/share knowledge Speak up Speak up Healthy staff/heal individual wounds Healthy staff/heal individual wounds Be passionate Be passionate Management training Management training Advance career Advance career Role modeling Role modeling Build trust, team, support Build trust, team, support Process improvement Process improvement Listen Listen Rebel Rebel Others? Others?

21 Action Plan: What action do you want to take to increase cultural competency and/or disrupt racism in your practice and/or organization? What action do you want to take to increase cultural competency and/or disrupt racism in your practice and/or organization? What resources or materials, if any, would you need to achieve your goal? What resources or materials, if any, would you need to achieve your goal? What behaviors or steps would taking this action entail? What behaviors or steps would taking this action entail? What is a realistic timeline for carrying out the steps involved in this action plan? What is a realistic timeline for carrying out the steps involved in this action plan?

22 What hazards or risks are involved? What hazards or risks are involved? What obstacles might you encounter? What obstacles might you encounter? What could you do to overcome these obstacles? What could you do to overcome these obstacles? What supports do you have? What supports do you have? Where could you find more support? Where could you find more support? How could you evaluate your success? How could you evaluate your success? Action Plan:

23 Resources:

24 Resources/References: “What Language Does Your Patient Hurt In?,” Salimbene, S. “What Language Does Your Patient Hurt In?,” Salimbene, S. “A Peoples History of the United States,” Zinn, H., New York: Perennial, “A Peoples History of the United States,” Zinn, H., New York: Perennial, “Race, Class, and Gender in the United States,” Rothenberg, P. (Ed.), New York: Worth Publishers, “Race, Class, and Gender in the United States,” Rothenberg, P. (Ed.), New York: Worth Publishers, “Pedagogy of the Oppressed,” Freire, P., New York: Continuum, “Pedagogy of the Oppressed,” Freire, P., New York: Continuum, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and Collision of Two Cultures by Anne Fadiman The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and Collision of Two Cultures by Anne Fadiman “Educating for a Change,” Arnold, Burke, James, Martin, Thomas, Toronto: BTL, “Educating for a Change,” Arnold, Burke, James, Martin, Thomas, Toronto: BTL, Film: “The Color of Fear,” Butler, R. Stir Fry Productions Film: “The Color of Fear,” Butler, R. Stir Fry Productions Film: “The Way Home,” Butler, S. Oakland, CA.: World Trust, Film: “The Way Home,” Butler, S. Oakland, CA.: World Trust, 2002.

25 Thank You! C. Truth Griffeth, LCSW, CDP, NCAC Native Instincts Consulting Group (206)


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