L7 - Cross-Cultural Competence

Question 1

What is culture?

Answer 1

“intergenerational transmission of traditions, ways of living, coping behaviors, values, norms, and beliefs”

• It is dynamic & changing, learned, socially shared*
• Shaped by cultural, political and social contexts*

Question 2

What are the 3 areas we must be fluent in when dealing with other cultures to ensure we have cultural competence?

Answer 2

1. Knowledge
2. Awareness
3. Skills

Question 3

What does the area of knowledge mean in regards to cultural competency?

Answer 3

Knowledge of the influence of social and cultural backgrounds on beliefs, understandings of the world, behaviours etc.

knowledge must be specific to the particular culture you are working with

Question 4

What does awareness refer to in regards to us being culturally competent?

Answer 4

Awareness of

1. our own values and biases

2. the impact of our own cultural outlook and the influence that has on understandings/interpretations

3. the interaction with the client

Question 5

What does skills refer to in regards to cultural competency?

Answer 5

• skills in providing the right treatment*
  1. Adaptation of knowledge (clinical) to meet individual needs on the basis of cultural differences
  2. The ability to provide treatment/therapy/interventions to best suit the client

Question 6

There is an organizational level to cultural competence - what does this mean?

Answer 6

Means having the necessary tools and services required for treating patients from different cultural backgrounds

• e.g. materials available (do they translate into the right language, are interpreters available, are the right materials on display for clients in waiting areas)*
• • is there enough funding allocated?*
• • what assessment/training is available?*

Question 7

Why is organizational cultural competency of great importance?

Answer 7

The is an underutilization of service by many groups of people because they see them as culturally inappropriate which leads them to believe they are unsafe and avoid them

Question 8

Are there any disparities in health and health care between refugees and local populations?

Answer 8

Yes

Higher levels of suicide and mental health issues in some marginalized cultural groups

Higher levels of physical health issues, such as diabetes

Question 9

In psychology, being culturally competent means:

4 points

Answer 9

1. Knowledge of the importance of social and cultural influences on health
   beliefs and behaviours – including our own!

• e.g. DSM – working towards including mental health issues from non-
western cultures

2. Having awareness of different outlooks on mental health for different
   groups of people
3. Skills in working and communicating with people from diverse
   backgrounds
4. Culturally appropriate therapies and interventions

Question 10

Summarise the 7 APA guidelines for working with refugees as a psychologist

Answer 10

1. Educate their clients about psych intervention (e.g. goals, expectations etc.)

2. Aware of relevant research and practice issues related to the refugee population.

3. Recognize ethnicity and culture as significant parameters for understanding clients

4. Respect the role of family members and community structures, hierarchies, values, beliefs in the clients culture.

5. Respect clients religious/spiritual beliefs (including taboos, values, how they express distress)

6. Use the language requested by client (refer to another if not possible)

7. Consider the impact of adverse social, environmental and political factors when assessing problems and designing interventions

Question 11

What are the 3 barriers to Cross-Cultural Competency in Health Care as outlined by Betancourt, et al., (2003)

Answer 11

1. Organisational Barriers

2. Structural Barriers

3. Clinical Barriers

Question 12

What does Betancourt’s (2003) Organisational Barriers refer to in regards to cross-cultural competency in health care?

Answer 12

Leadership Roles

we should take efforts to make leadership or workforces representative of the client population

Question 13

What does Betancourt’s (2003) Structural Barriers refer to in regards to cross-cultural competency in health care?

Answer 13

Interpreting services

we should take care to make sure there is appropriate access to interpreting services and culturally appropriate pamphlets etc. to overcome barriers

Question 14

What does Betancourt’s (2003) Clinical Barriers refer to in regards to cross-cultural competency in health care?

Answer 14

Interaction and communication - understanding different perspectives

to overcome cross-cultural barriers we need to equip and train staff using cross-cultural training etc.

Question 15

What are the main challenges and issues when using a cross-cultural approach to treatment?

Answer 15

1. guidelines are often general (i.e. relating to the process of cross-cultural competency

2. The best-practice will differ across groups of people - complicated

• • if working with specific group, need to develop understandings of the group*
• • if you cant, at least get a general understanding and use interpreters to help*

Question 16

What are the criticisms/caveats of the cultural competence approach?

Answer 16

It can run the risk of stereotyping groups of people

important to treat people as individuals and not assume that all people from the same culture will act in the same way

Question 17

What are the five main principles of trauma informed care?

Answer 17

1. Safety

(trauma fundamentally affects sense of safety, very important to work on this)

2. Trust

3. Choice

4. Empowerment

5. Working together