Professional Ethics and Law in California, 2nd Edition _ ____________________________________________
In positive culturally competent communication cli- mates, trust is established and reaffirmed, allowing freedom to explore sensitive issues and express disagreements. Positive
Recommendations to promote ethical cultural compe- tence were developed by the Georgetown University National Center for Cultural Competence (2009). Mental health prac- titioners can use these recommendations to promote ethical practice in cultural competence through the following: • Display materials that reflect cultures and ethnic backgrounds of clients within your practice . • Printed materials in your reception area are of interest to and reflect cultures of people served . • Treatment aids such as play therapy and games reflect cultures of people served . • Attempt to learn and use key words in client’s language . • Attempt to determine familial colloquialisms that impact assessment and treatment . • Use visual aids, gestures, and physical prompts when appropriate with clients who are limited in English proficiency . • Utilize bilingual colleagues or trained and certified interpreters to assist you with assessment and treatment . • Try to ensure that all written communication, including consent forms, are written in client’s first language . • Screen books before sharing them with clients . • Recognize that clients have varying degrees for acculturation . • Understand that meaning or value of medical treatment, health care, and health education varies in clients . • Understand that beliefs and concepts of emotional well-being vary from culture to culture . • Understand that mental health and emotional disability are culturally based and that responses to these conditions are influenced by culture as well . • Recognize that folk and religious beliefs may influence a family’s reaction and approach to a child born with a disability or later diagnosed with physical/emotional disability or special health care needs . • Understand that traditional approaches to disciplining children are influenced by culture . • Understand that families from different cultures will have different expectations of their children for acquiring toileting, dressing, feeding, and other self-help skills . • Accept and respect that customs and beliefs about food, its value, preparation, and use are different from culture to culture .
talk climates are: • Descriptive • Oriented toward problems • Spontaneous • Empathic • Express equality • Provisional
Common Errors in Demonstrating Cultural Competence Demonstrating ethical behavior in cultural competency can be somewhat confusing for mental health practitioners, depending on their regional, cultural, and linguistic orienta- tion. However, common errors demonstrated by often well- meaning professionals include: • Unintentional racism • Miscommunication • Lack of personal awareness • Insensitivity to nonverbal cues • Lapse in discussion of racial/ethnic issues • Gender bias • Overemphasis of cultural explanations for psychological difficulties • Lapse in including appropriate questions within the context of acquiring background information • Inability to appropriately present questions that elicit valuable information or feedback • Nonparticipation in multicultural activities that facilitate cultural awareness that would include interactions among people of similar and different racial identities • Little or no processing of cultural difference in supervision • Inability to identify multiple hypotheses and integrate this information in a culturally competent manner into a client’s presenting problem A lack of cultural awareness can manifest as “microaggres- sions,” which are a form of often unconscious racist behavior. Examples of microaggressions are complimenting a U.S.-born Asian American person’s English or “over-identifying” by asserting that as a woman one understands the oppression suffered by African Americans. It is often assumed of African American women that they are “strong” (Williams, 2013). It is important to reflect on one’s own assumptions and biases. Although microaggressions are common and may seem mild to those not on the receiving end, research shows that an accu- mulation of microaggressions can harm mental and physical health. When the microaggressions come from healthcare and service providers, they can erode trust in the system.
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