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What is "cultural competence"?
Culture is an aspect of identity, which we all have. Culture is
based on a number of things shared with others such as language, shared history, beliefs,
attitudes, celebrations, musical taste, dress, diet and many others. Culture is basically about a
shared understanding with others of the same culture. Cultures are neither inferior or superior –
they are just different.
In health and social care, there has been a shift in recent years
towards ‘cultural competence’ as a key aspect of all professional practice. The idea of workers
being ‘competent’ in working with others from different cultures is a step on from being
‘sensitive’ to the needs of other people. The notion that professionals need to be competent in
working with difference and culture as opposed to being merely ‘sensitive’ about it has gained
strength in recent years. The term cultural competence has therefore largely replaced the term
cultural sensitivity in social work and health care.
If workers are to be seen as culturally competent, then they need
to be able to articulate what cultural competence is. Conversely, the very concept of
competence implies that those who do not hold sufficient knowledge and understanding about the role
of people’s culture are by definition ‘incompetent’ at their job if they cannot work in an
effective way to meet people’s diverse needs.
There is a long standing view that competence is made up of
knowledge, values and skills (e.g.: Maclean and Caffrey 2009). This can be represented in the
following diagram:
We feel that a triangle provides a good
representation of cultural competence because the skills (at the top of the triangle) are supported
by a worker having the necessary knowledge and values.
In our view, culturally competent practice
involves:
1. Knowledge and understanding
of:
- your own culture
- any culture bias you have
- the concept of culture and how this can
affect beliefs and behaviours
- specific cultural
knowledge
2. A range of values and attitudes, including
a commitment to:
- valuing and celebrating
difference
- respecting individuality and the role which
culture plays in this
3. And a range of skills,
including:
- culturally competent
communication
- culturally competent
assessment
- culturally sensitive care
provision
It is important to recognise that culture is
an aspect of a person’s identity. It is not their ‘whole’ identity and it does not act as a
predictor of how a person will behave and what they will believe. Everyone will choose which
aspects of their cultural identity they will ‘own’ and which they will not. As such, each person
will have a unique approach to their culture – leading to a complexity of ways in which culture
will affect people’s individual needs and preferences.
Cultural Competence and Self Awareness for
workers in Health and Social Care
If workers in social and health care are to
be culturally competent, they need to develop some key skills and knowledge for effective practice.
In order to appreciate the different cultures to which people associate fully and to form effective
working relationships with service users and carers, it is important to understand the diversity
there is within daily life.
Within all cultures and religious groups
there is wide variation in practice and it is important to realise that degrees of strictness and
observance are individually defined. Culturally competent workers will appreciate that culture is
not monolithic and it will be dangerous to provide services based on stereotypical concepts of, for
example, "a Jew", "a Hindu", or "a Muslim". Some people born into a religious community may not
consider themselves to be members of that community. For others their religion, traditions and
rituals may be important, but they may not observe, say, strict dietary requirements. Therefore, it
is important to allow individuals to define their own culture and religion.
The way in which a person views themselves
and their identity will be affected by their culture and their religion, but this can vary between
different groups and according to individual personal preferences. The way we live our lives is
affected by the environment in which we all live.
If we accept that cultures are not better or
worse than each other, but are just different, then we need to be clear that some of the ideas and
‘truths’ that we bring to our work are themselves culturally rooted. As workers in social and
health care we also have our own culture, both as individuals in society and as employees of
organisations and members of teams which have cultures. Culturally competent practice involves
understanding the values we bring to our work, and a sophisticated awareness of how oppression,
stereotyping of other people’s culture and prejudice operate to disadvantage others. A competent
practitioner is able to understand these concepts, see how they relate to their practices, and
reflect on their own values and ‘truths’ about both their own and other people’s
cultures.
Robinson (2007: 169)
states:
"An etic refers to a universal truth or
principle, whereas an emic refers to truths that are culture specific."
People who work with others must have some
understanding of the fact that not all of the truths we grew up with are etics in order to
appreciate the impact which our own culture and upbringing has had on our beliefs about the world.
We cannot work effectively with other people who have different emics to our own if we insist that
all of their ‘truths’ (i.e.: their beliefs, values, aspirations etc) should be the same as
ours.
The new book "Developing Cultural Competence in Social and Health
Care" explores how a
culturally competent practitioner can develop their self awareness, communication and assessment
skills in order to ensure effective practice in working with people. It also examines the ways in
which failing to do so can lead to poor practice in the field of safeguarding and child protection,
as well as stating the case for organisations to develop their cultural
competence.
"
Developing Cultural Competence in Social
and Health Care"
The new book by Rob Harrison, Rachel Harvey
and Siobhan Maclean replaces the previous text "Cultural Sensitivity in Social and Health Care".
This book aims to provide workers with a good overview of the key concepts around cultural
competence, and some useful working knowledge about various cultures.
Cultures are not static and people never fit
into neat cultural boxes. It is absolutely vital for all professionals in health and social care
work to remember the dangers of making assumptions about people’s needs and wishes based on how
their culture is supposed to operate. Culturally competent workers recognise every individual as
unique and equally worthwhile. Although this book aims to provide information about cultures and
religions which can be helpful as basic knowledge, a culturally competent reader will avoid
assumptions at all stages of working with people.
Part 1 of the book explores the concept of
cultural competence in health and social care in order to develop professionals’ understanding of
Cultural Competence, and how the concept relates to every aspect of their practice. This section
explores the following areas:
What is Cultural
Competence?
Understanding the Key Terms
Recognising Cultural Diversity in the
UK
Exploring Other Aspects of
Culture
Diversity and
Discrimination
Understanding Your Own
Culture
Communicating with People from a Different
Cultural Background
Culturally Competent Assessment
Practice
Child Protection and Cultural
Diversity
Culturally Competent
Organisations
Cultural Competence: Good Practice
Guidelines
Part 2 considers specific Religions and
Cultures in order to provide some key basic knowledge for workers in social care and health
settings about the following cultures and world religions:
African Caribbean Culture
Buddhism
Chinese Culture
Christianity
Hinduism
Islam
Jainism
Jehovah’s Witnesses
Judaism
Rastafarianism
Refugees and Asylum Seekers
Sikhism
Travellers
White Minorities and Economic
Migrants
Culturally competent practice is certainly a
challenge for everyone working in an already challenging field. However, the effort that it takes
is worth it not just because culturally competent practice provides the best service for everyone,
but also because the ‘challenge’ can take us on an enjoyable journey.
References:
Maclean, S. and Caffrey, B. (2009)
Developing a Practice Learning
Curriculum. (Rugeley) Kirwin Maclean Associates
Ltd.
Robinson, L. (2007)
Cross-Cultural Child Development for Social Workers: An
Introduction. (Basingstoke) Palgrave
MacMillan.
You can see more information about the
book HERE
.
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