8.3: What it means to be Culturally Competent

The development of culturally responsive clinical skills is vital to the effectiveness of behavioral health services. According to the U.S. Department of Health and Human Services (HHS), cultural competence “refers to the ability to honor and respect the beliefs, languages, interpersonal styles, and behaviors of individuals and families receiving services, as well as staff members who are providing such services. Cultural competence is a dynamic, ongoing developmental process that requires a long-term commitment and is achieved over time” (HHS 2003a, p. 12). It has also been called “a set of behaviors, attitudes, and policies that . . . enable a system, agency, or group of professionals to work effectively in cross- cultural situations” (Cross et al. 1989, p. 13).

This section targets specific racial, ethnic, and cultural considerations along with the core elements of cultural competence highlighted in the model. These core elements include cultural awareness, general cultural knowledge, cultural knowledge of behavioral health, and cultural skill development.

Introduction to Cultural Competence

Why is the development of cultural competence and culturally responsive services important in the behavioral health field? Culturally responsive skills can improve offender engagement in services, therapeutic relationships between offender and providers, and treatment retention and outcomes. Cultural competence is an essential ingredient in decreasing disparities in behavioral health.

The development of cultural competence can have far-reaching effects not only for offender, but also for providers and communities. Cultural competence improves an organization’s sustainability by reinforcing the value of diversity, flexibility, and responsiveness in addressing the current and changing needs of offender, communities, and the healthcare environment. Culturally responsive organizational strategies and clinical services can help mitigate organizational risk and provide cost-effective treatment, in part by matching services to offender needs more appropriately from the outset. So too, culturally responsive organizational policies and procedures support staff engagement in culturally responsive care by establishing access to training, supervision, and congruent policies and procedures that enable staff to respond in a culturally appropriate manner to offender’ psychological, linguistic, and physical needs.

What is the process of becoming culturally competent as a correctional professional or culturally responsive as an institution?

Cultural competence is not acquired in a limited time frame or by learning a set of facts about specific populations; cultures are diverse and continuously evolving. Developing cultural competence is an ongoing process that begins with cultural awareness and a commitment to understanding the role that culture plays in behavioral health services. For correctional professionals, the first step is to understand their own cultures as a basis for understanding others. Next, they must cultivate the willingness and ability to acquire knowledge of their offender’ cultures. This involves learning about and respecting offender worldviews, beliefs, values, and attitudes toward mental health, help-seeking behavior, substance use, and behavioral health services. Correctional professionals should incorporate culturally appropriate knowledge, understanding, and attitudes into their actions (e.g., communication style, verbal messages, treatment policies, services offered), thereby conveying their cultural competence and their institutions’ cultural responsiveness during assessment, treatment planning, and the treatment process.

What is culture?

Culture is the conceptual system developed by a community or society to structure the way people view the world. It involves a particular set of beliefs, norms, and values that influence ideas about relationships, how people live their lives, and the way people organize their world. Culture is not a definable entity to which people belong or do not belong. Within a nation, race, or community, people belong to multiple cultural groups and negotiate multiple cultural expectations on a daily basis. These expectations, or cultural norms, are the spoken or unspoken rules or standards for a given group that indicate whether a certain social event or behavior is appropriate or inappropriate. The word “culture” is sometimes applied to groups formed on the basis of age, socioeconomic status, disability, sexual orientation, recovery status, common interest, or proximity. Correctional professionals and administrators should understand that each offender embraces his or her culture(s) in a unique way and that there is considerable diversity within and across races, ethnicities, and culture heritages. Other cultures and subcultures often exist within larger cultures.

What are race and ethnicity?

Race is often referred to as a biological category based on genetic traits like skin color (HHS 2001), but there are no reliable means of identifying race through biological criteria. Despite its limitations, the concept of race is important to discussions of cultural competence. Race— when defined as a social construct to describe people with shared physical characteristics— can have tremendous social significance. The term ethnicity is often used interchangeably with race, although by definition, ethnicity— unlike race—implies a certain sense of belonging. It is generally based on shared values, beliefs, and origins rather than shared physical characteristics. With the exception of its final chapter, which examines drug cultures, this TIP focuses on the major racial and ethnic groups identified by the U. S. Census Bureau within the United States: African and Black Americans, Asian Americans (including Native Hawaiians and other Pacific Islanders), Hispanics and Latinos, Native Americans, and White Americans.

What constitutes cultural identity?

Cultural identity, in the simplest terms, involves an affiliation or identification with a particular group or groups. An individual’s cultural identity reflects the values, norms, and worldview of the larger culture, but it is de- fined by more than these factors. Cultural identity includes individual traits and attributes shaped by race, ethnicity, language, life experiences, historical events, acculturation, geographic and other environmental influences, and other forces. Thus, no two individuals will possess exactly the same cultural identity even if they identify with the same cultural group(s). Cultural identities are not static; they develop, evolve, and change across the life cycle.