1. Culturally Responsive Practice: Every Day, in Every Way
Creating Partnerships within the Context of Culture
Suzanne M. Bronheim, Ph.D., National Center for Cultural Competence
Mercedes Rosa, Statewide Parent Advocacy Network
Dee Spinkston, Urban PRIDE
Strand
Presentation 309(317)

2. National Center for Cultural Competence
Georgetown University Center for Child and Human Development
University Center of Excellence in Developmental Disabilities

5. Culture
Culture is an integrated pattern of human behavior which includes but is not limited to:
roles
values
rituals
communication
languages
relationships
courtesies
thought
beliefs
practices
customs
manners of
interacting
expected
behaviors
… of a racial, ethnic, religious, social, or political group; the ability to transmit
the above to succeeding generations; dynamic in nature.
Slide Source: The National Center for Cultural Competence, 2007
Slide Source: National Center For Cultural Competence ©2011

6. Cultural Factors That Influence Diversity Among Individuals and Groups
Internal Factors
Health Literacy
Perception of Disability or Mental Health
Lived Experience of Disability or Mental Illness
Age & Life Cycle Issues
Gender, Gender Identity & Expression
Sexual Orientation
Religion & Spiritual Views
Spatial & Regional Patterns
Political Orientation/Affiliation
Cultural/Racial/Ethnic Identity
Tribal Affiliation/Clan
Nationality
Acculturation/Assimilation
Socioeconomic Status/Class
Education
Language
Literacy
Family Constellation
Social History
Perception of Time
Health/Mental Health
Beliefs & Practices
Adapted with permission from James Mason, Ph.D., NCCC Senior Consultant
Slide Source:© National Center for Cultural Competence

7. Cultural Factors That Influence Diversity Among Individuals and Groups
External Factors
Institutional Biases
Racism & Discrimination
Community Economics
Intergroup Relations
Group & Community Resiliency
Natural Networks of Support
Community History
Political Climate
Workforce Diversity
Community Demographics
Adapted with permission from James Mason, Ph.D., NCCC Senior Consultant
Slide Source:© National Center for Cultural Competence

8. Culture as Lens
Our beliefs, values, experiences and cultural expectations create a lens that gives meaning to our world. Each lens is different and all interactions are somewhat cross-cultural.
Slide Source:© National Center for Cultural Competence

9. An Iceberg Concept of Culture
dressage
gender  language
 race or ethnicity 
physical characteristics
eye behavior
 facial expressions 
Adapted by the NCCC
 body language sense of self 
 gender identity 
notions of modestyconcept of cleanliness
 emotional response patterns rules for social interaction child rearing practices 
decision-making processes 
approaches to problem solving 
 concept of justice value individual vs. group 
 perceptions of mental health, health, illness, disability 
 patterns of superior and subordinate roles in relation to status by age, gender, class  sexual identity & orientation 
and much more…
Slide Source:© National Center for Cultural Competence

10. Creating Partnerships within the Context of Culture
Need a shared “lens” on:
Is there a problem?
What is the problem?
What are the choices?
What principles guide the choices?
Who are the decision makers?
What are the roles of the “team”?
Slide Source:© National Center for Cultural Competence

11. Definition & Framework
Cultural Competence
Definition & Framework

12. (adapted from Cross, Bazron, Dennis and Isaacs, 1989)
Cultural Competence
behaviors
attitudes
policies
structures
practices
requires that organizations have a clearly defined, congruent set of values and principles, and demonstrate behaviors, attitudes, policies, structures, and practices that enable them to work effectively cross-culturally
(adapted from Cross, Bazron, Dennis and Isaacs, 1989)
Slide Source:© National Center for Cultural Competence
Slide Source:© National Center for Cultural Competence

13. Five Elements of Cultural Competence
Organizational Level
value diversity
conduct cultural self-assessment
manage the dynamics of difference
institutionalize cultural knowledge
adapt to diversity
- policies - structures
- values services
(Cross, Bazron, Dennis and Isaacs, 1989)
Slide Source:© National Center for Cultural Competence

14. Five Elements of Cultural Competence
Individual Level
acknowledge cultural differences
understand your own culture
engage in self-assessment
acquire cultural knowledge & skills
view behavior within a cultural context
(Cross, Bazron, Dennis and Isaacs, 1989)
Slide Source:© National Center for Cultural Competence
Slide Source:© National Center for Cultural Competence

15. ESSENTIAL ELEMENTS IN A CULTURALLY COMPETENT SYSTEM
These five elements must be manifested at every level of an organization including:
policy makers
administration
practice & service delivery
patient/family/consumer
community
and reflected in its attitudes, structures, policies, practices, and services.
Adapted from Cross, Bazron, Dennis, & Isaacs, 1989
Slide Source:© National Center for Cultural Competence

16. What Cultural Competence is Not
Cookbook approaches to specific racial or ethnic groups
Translating materials into other languages as the only action
Making alterations in programs/approaches at one point in time
Treating everyone the same
Only the concern of providers/employees
Slide Source:© National Center for Cultural Competence

17. Cultural Competence Continuum
(Cross, Bazron, Dennis and Isaacs, 1989)
Cultural Proficiency
Cultural Competence
Cultural Pre-Competence
Cultural
Blindness
Cultural Incapacity
Cultural Destructiveness
Slide Source:© National Center for Cultural Competence

18. Definition of Linguistic Competence
The capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, individuals with disabilities, and those who are deaf or hard of hearing. Linguistic competency requires organizational and provider capacity to respond effectively to the health and mental health literacy needs of populations served. The organization must have policy, structures, practices, procedures, and dedicated resources to support this capacity.
Goode & Jones (modified 2009). National Center for Cultural Competence, Georgetown University Center for Child & Human Development.
Slide Source:© National Center for Cultural Competence

19. What will it take to create partnerships in a cultural context?
Programs/service and support organizations
Systems and organizations must sanction, and in some cases mandate the incorporation of cultural knowledge into policy making, infrastructure and practice.*
Cultural competence embraces the principles of equal access and non-discriminatory practices in service delivery
* Adapted from Cross, T. et al, 1989
Slide Source:© National Center for Cultural Competence

20. What will it take to create partnerships in a cultural context?
Programs/service and support organizations
identify and understand the needs and help-seeking behaviors of individuals and families.*
design and implement services that are tailored or matched to the unique needs of individuals, children, families, organizations and communities served.*
provide services driven by client preferred choices, not by culturally blind or culturally free interventions.*
* Adapted from Cross, T. et al, 1989
Slide Source:© National Center for Cultural Competence

21. What will it take to create partnerships in a cultural context?
Professionals, administrators, program staff:
Examine and know own cultural values
Elicit information about family and cultural beliefs, values and concerns related to the focus of the partnership
Include cultural considerations in all service plans, program development, program evaluation
Know natural support networks in community served
Know how and families view community services and supports
Slide Source:© National Center for Cultural Competence

22. What will it take to create partnerships in a cultural context?
Professionals, administrators, program staff:
Get regular feedback from families about the process of partnership and the outcomes –services and supports

23. What will it take to create partnerships in a cultural context?
Families and youth
Identifying your values and beliefs
Providing information to professionals, program staff or other partners about what you think a problem might be, acceptable solutions, key decision makers, roles for you, your child/youth, others, providers
Slide Source:© National Center for Cultural Competence

24. What will it take to create partnerships in a cultural context?
Families and youth
Identifying authorities/cultural brokers in your cultural community to help inform providers
Learning to talk about culture
Slide Source:© National Center for Cultural Competence

25. What will it take to create partnerships in a cultural context?
Family organizations
Examine and know own cultural values
Elicit information from families about cultural beliefs, values and concerns
Include cultural considerations in your intake procedures
Know natural support networks in community served
Know how families view community supports
Slide Source:© National Center for Cultural Competence

26. What will it take to create partnerships in a cultural context?
Family organizations
Elicit information about families views on advocacy
Don’t challenge authority
Experiences of discrimination and bias
Experiences of trauma
Immigration issues even if documented
Support needs for language access within your organization and with providers
Advocate for systems to address cultural issues
Be a champion
Slide Source:© National Center for Cultural Competence

27. What will it take to create partnerships in a cultural context?
Family organizations
Assess your awareness, knowledge and skills
Advocates that reflect the diversity of the community served
Address language access
Dynamics of difference—build skills
Partner with support networks in community served
Policies to support cultural and linguistic competence
Slide Source:© National Center for Cultural Competence

28. Cultural and linguistic competence is a life’s journey …
not a destination
Safe travels!
Slide Source:© National Center for Cultural Competence

29. Cultural Competence with Immigrant & LEP Families: A Parent Organization Perspective
Presented by Mercedes Rosa, Project Director
Family to Family Health Info Center
CHIPRA Immigrant Outreach & Enrollment Project
Culturally Competent Outreach & Support Project
Statewide Parent Advocacy Network (SPAN)

30. SPAN’s Mission
To empower families & inform & involve professionals & others interested in the healthy development & education rights of children, to enable them to become fully participating & contributing members of our communities & society.

31. SPAN’s Commitment
SPAN’s foremost commitment is to children with the greatest need due to disability, special health or mental health needs; poverty; discrimination based on race, sex, language, or immigrant status; geographic location; or family or other special circumstances

32. SPAN’s Motto & Focus Empowered Parents: Educated, Engaged, Effective!
Focus = enhance the leadership of every parent
Within their family
Within their community
In systems change

33. Strengths-based
Parent leadership development thru peer-to-peer education, support & empowerment
Parents can be leaders regardless of their current situation

34. Strengths-based We build leadership, not dependence
We measure our effectiveness in enhancing family confidence, competence, attitudes & skills
We ask families to assess our work

35. Engage families at all levels
We routinely ask, listen to, & incorporate the voices of diverse families in:
Our programs & services
Policy Development
We provided needed supports
“Nothing about me, without me.”

36. Language access Multi-lingual staff Community partnerships
Language Line
Website translation
Traducelo Ahora
Websites s

37. Cultural reciprocity
Developing reciprocal relationships of trust with families
Asking families what will work for them
“Do unto others as they would have you do unto them.”
“Seek first to understand, then to be understood.”

38. Cultural Brokers
Identify partners with legitimacy with families & targeted communities.
Develop reciprocal trusting relationships

39. Self-Assessment
Conduct cultural & linguistic competence self-assessment using NCCC tool
Conduct language access assessment
Develop improvement plans

40. Self-Assessment
Collect & analyze data based on race, language, etc. to measure effectiveness & to identify the need for policy improvements

41. Flexibility
Provide information & training at convenience times & locations, in multiple languages & formats

42. Targeted services
Target families from underserved communities for more intensive supports designed to be flexible & responsive to their specific needs

43. Catalyst for Change
Helping education, health, and other service delivery systems:
Recognize the barriers for families
Make changes to address barriers
Engage families in all processes

44. Commitment People say, what is the sense of our small effort.
They cannot see that we must lay one brick at a time, take one step at a time.
A pebble cast into a pond causes ripples that spread in all directions. Each one of our thoughts, words and deeds is like that.
No one has a right to sit down and feel hopeless.
There’s too much work to do.