1. The Cultural Competence Model February 10 New Grantee Meeting Washington DC Andy Hunt, MSW Captain, US Public Health Service SAMHSA Project Officer

2. Workshop Objectives 1. Understand and define the term “cultural competence” and identify the five elements of the Cultural Competence Model. 2. Increase awareness of one’s own culture and your reactions to cultural differences. 3. Provide common understanding, language and framework for the new CLC Coordinators.

3. Session Outline I. Definition of “cultural competence” and exploring concept of “culture” II. Human needs and culture III. Discussion on influences of culture in help seeking and service provision IV. Distinction between “awareness” and “competence” V. Five Elements of Cultural Competence

4. Cultural Competence The state of being capable of functioning effectively in the context of cultural differences. (Cross, et. al) The majority of the content of this presentation is adapted from Cross, Bazron, Dennis and Isaacs, Toward a Culturally Competent System of Care… 1989.

5. What is “culture”? Let’s brainstorm…

6. Webster’s definition of “culture” The integrated pattern of human knowledge, belief, and behavior that depends upon man's capacity for learning and transmitting knowledge to succeeding generations The customary beliefs, social forms, and material traits of a racial, religious, or social group The set of shared attitudes, values, goals, and practices that characterizes a company or corporation

7. Maslow’s Hierarchy of Needs Food Formal l aws/rules Family & parenting Housing Clothing Social rules Religious institutions Social activities Spirituality Stories Art, music, dance Ceremonies

8. Human Needs and Culture Practically speaking, “culture” can be viewed as one group of people’s preferred way of meeting their basic human needs  Examples… This has implications for providing services, especially in system of care where the community is culturally diverse People tend to have a strong, if unconscious, desire to for their core cultural preferences to meet needs  Trust in others from people “like me”  Desire for familiarity of surroundings

9. Potential Areas for a “cultural bump” in Systems of Care Concepts of mental health, healing, help seeking, and wellness belief systems Perceptions and explanations of the causes of problems with emotions, mental states, and behavior in children and families Behavior and coping strategies of family members and their attitudes toward, and expectations of professional helpers Service delivery structure and process that may not be congruent with the community’s preferences Other examples…

10. “Culture is to people as water is to fish” Please discuss the following statement, and how it relates to working with children and families…

11. What is the best treatment for the common cold?

12. Do unto others?? Example for discussion: Chicken soup or Vicks VapoRub for your sick friend? If “programs and services” are set up with the idea that everyone likes/needs Vicks Vapor Rub when they have a cold…  What happens to those who like/need the chicken soup remedy?

13. Awareness or Competence? Awareness  having or showing realization, perception, or knowledge  implies vigilance in observing or alertness in drawing inferences from what one experiences Competence  The state of being competent  having the capacity to function or develop in a particular way; specifically: having the capacity to respond

14. Competence a Continuum of ability and skills…

17. Cultural Competence Continuum Destructiveness Incapacity Blindness Pre-Competence Basic Competence Advanced Competence © 1989 Cross, et. al

18. Ongoing Cultural Competence Cultural competence clearly implies the ability to take action, adapt and function in a different environment It is a commitment to a developmental process - not a “check box” that you either have or do not have Elements should be integrated into all aspects of program, policy and services and not viewed as a separate component

19. Five Elements of Cultural Competence (at the Individual Level) 1. Awareness and acceptance of difference 2. Awareness of own cultural values 3. Understanding and managing for the “dynamics of difference” 4. Development of cultural knowledge 5. Ability to adapt practice to fit the cultural context of the client/family

20. Five Elements of Cultural Competence (at the Organizational Level) 1. Values Diversity 2. Cultural Self Assessment 3. Manages the “dynamics of difference” 4. Institutionalizes cultural knowledge 5. Adaptation to diversity

21. The “Dynamics of Difference” What happens when people from two cultures meet…each person interprets the responses of others within the context of his/her own cultural experience. This interaction is affected by differences in:  Language and communication style  Economic opportunity  Family configuration and kinship structures  How problems are defined or solved  Non-verbal communication  Political, historical influences Examples…

22. Range of “Dynamics of Difference” Valuing Diversity Understanding Awareness Idealism (Romanization) Ethnocentrism Prejudice Bigotry Racism Institutional Racism Genocide

23. Practical Suggestions Know what you don’t know… Be open to learning through the act of unintentionally offending members of a cultural community different than your own Find opportunities to get honest feedback by developing relationships with cultural brokers Observe natural behavior of groups and adapt practices and programs accordingly Don’t think that you are “done” or have “arrived” at cultural competence

24. Next Steps Use this model as a framework Do a self assessment Make a commitment to the process of enhancing your cultural competence Develop a plan for action Share what you learned Do something different

25. Thank You The majority of the content of this presentation is adapted from: Cross, Bazron, Dennis and Isaacs, Toward a Culturally Competent System of Care… 1989. For additional questions about this presentation contact: CAPT Andy Hunt, MSW, LICSW SAMHSA/CMHS 1 Choke Cherry Road, Room 6-1054 Rockville, MD 20857 Phone: 240-276-1926 Fax: 240-276-1930 Andrew.hunt@samhsa.hhs.gov