Cultural Competence Copy

Defining Culture

Over the past three decades, there has been an increased understanding in the health and behavioral health professions that cultural competence was an important part of being able to achieve successful outcomes. Since that time, cultural competence has been included in most professional practice guidelines and codes of ethics. Before we can examine cultural competence, it is important to understand exactly what culture is and how culture affects the people we serve. Simply understood, the key elements that constitute a culture are:

  • A common heritage and history that is passed from one generation to the next
  • Shared values, beliefs, customs, behaviors, traditions, institutions, arts, folklore, and lifestyle
  • Similar relationship and socialization patterns
  • A common pattern or style of communication or language
  • Geographic location of residence
  • Patterns of dress and diet.

Culture is:

 An integrated pattern of human behavior that includes thoughts, communications, languages, practices, beliefs, values, customs, courtesies, rituals, manners of interacting and roles, relationships and expected behaviors of a racial, ethnic, religious or social group; and the ability to transmit the above to succeeding generations.

Peer support specialists have a responsibility to adapt and modify their personal behavior and support strategies appropriately in response to individual differences that influence client behavior. When taken together, these specific differences make up a person’s “culture.”

Culture influences many aspects of our lives from how we communicate and celebrate to how we perceive the world around us. Culture involves shared customs, values, social rules of behavior, rituals and traditions, and perceptions of human nature and natural events. Elements of culture are learned from others and may be passed down from generation to generation. The importance of culture is heightened in the lives of those living in a socio-cultural setting other than the one into which they were born. For people living in their native culture, cultural issues might arise first when they have interactions with individuals who do not share the same culture of origin. One way to bridge differences is through learning about other cultures. The ability to respond appropriately to cultural differences is often referred to as “cultural competence.

In this context, culture is a broad term that is defined as:

An integrated pattern of human behavior that includes thoughts, communications, languages, practices, beliefs, values, customs, courtesies, rituals, manners of interacting and roles, relationships and expected behaviors of a racial, ethnic, religious or social group; and the ability to transmit the above to succeeding generations.

An ethical peer support specialist knows that personal values influence the peer relationship and honors the personal values of his or her clients. Assisting in the client’s change process without compromising or undermining the client’s independence or self-determination can presents a challenge. Every person’s view of the world is developed from their unique combination of personal and cultural perspectives. It is natural and inevitable that peer support specialists will sometimes have views and experiences that differ from those of their clients.

Characteristics that Define a Person’s Cultural Identity

  • National origin
  • Customs and traditions
  • Length of residency in the US
  • Language
  • Age
  • Generation
  • Gender
  • Religious beliefs
  • Political belief
  • Sexual orientation
  • Perceptions of family and community
  • Perceptions of health, well-being, and disability
  • Physical ability or limitations
  • Socioeconomic status
  • Education level
  • Geographic location;
  • Family and household composition

A peer support specialist’s biases and world views can be felt by the client even if they are not spoken aloud. Unspoken assumptions can often carry more weight than those that are voiced, since the unspoken assumptions are not out in the open to be challenged or changed. A peer support specialist might want to invite discussion about his or her personal values while demonstrating the ability to respect and work with many alternative positions. A peer support specialist doesn’t need to be neutral about his or her values in order to be nonjudgmental.

Because the peer relationship is based on common or shared experiences, some might think that peer support specialists and clients must come from the same culture in order to have a successful relationship. This is neither true nor practical. Look at the long list of characteristics above. You could not possibly match a client on all of these things – and even if you did, each of you might understand or value these characteristics differently. That is why having the capacity to understand culture and the willingness to respect a client’s culture is so important.

Cultural Competence

Cultural competence is a fundamental ingredient that helps to develop trust, as well as an understanding of the way members of different cultural groups define health, wellness, addiction and recovery. Cultural competence is defined as: “a set of congruent behaviors, attitudes and policies that come together in a system, agency or among professionals and enables that system, agency or those professionals to work effectively in cross-cultural situations.”

Many people confuse cultural competence with cultural knowledge or cultural understanding. While knowledge and understanding are essential for cultural competence, by themselves, they are not enough. Since culture affects every person differently, to be fully culturally competent, a peer support specialist must possess certain skills. Peer support specialists can ask themselves these questions to determine their level of cultural competence:

  • Do I have close personal relationships with people who are culturally and socio-economically different?
  • Do I have the desire, knowledge, and skill to integrate culturally relevant considerations into my work?
  • How do my own cultural experiences and values impact the way I work?
  • Do I continuously engage in an open and honest dialogue about culture and diversity with diverse groups of people?

It is important to remember that clients, not peer support specialists, define what is culturally relevant to them. It is possible to damage the relationship with a client by making assumptions, however well intentioned, about the client’s cultural identity. For example, a client of Hispanic origin may be a third-generation United States citizen who feels little or no connection with her Hispanic heritage. A peer support specialist who assumes this client shares the beliefs and values of many Hispanic cultures would be making a generalization that is wrong. All of us represent multiple cultures. Peer support specialists should have a respectful dialog with clients around the cultural elements that have significance to them. This brief video provides a good explanation.

Video: What is Cultural Competence and Why is it Important? (2:44 minutes)