Assignment

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/224845530

Training Child Welfare Workers from an Intersectional

Cultural Humility Perspective: A Paradigm Shift

Article  in  Child welfare · January 2011

Source: PubMed

CITATIONS

105 READS

3,345

2 authors:

Some of the authors of this publication are also working on these related projects:

book revision View project

Robert M. Ortega

University of Michigan

22 PUBLICATIONS   592 CITATIONS   

SEE PROFILE

Kathleen Coulborn Faller

University of Michigan

124 PUBLICATIONS   2,260 CITATIONS   

SEE PROFILE

All content following this page was uploaded by Kathleen Coulborn Faller on 07 February 2015.

The user has requested enhancement of the downloaded file.

Training Child Welfare Workers from an Intersectional Cultural Humility Perspective: A Paradigm Shift

The increasing diversity of the populations encountered and served by child welfare workers challenges cultural competence models. Current concerns focus on the unin- tentional over-emphasis on shared group characteristics, undervaluing unique differ-

ences of individuals served, and privileging worker expertise about the client’s culture, thereby exacerbating the power imbalance between them. This article promotes cultural humil- ity in child welfare service delivery as a compliment to cultural competence, to liberate workers from expectations of cultural expertise about others, and to actively engage the clients, inclu- sive of their cultural differences, in the service delivery process. Skills and practice principles are discussed.

Robert M. Ortega University of Michigan

Kathleen Coulborn Faller University of Michigan

27Child Welfare • Vol. 90, No. 5

Within the past decade, child welfare services have seen aplethora of cultural competence training models designed to assure that cultural factors are taken into account when workers interact with children and families receiving child welfare services. Numerous resources have become available both online and in print to assist professionals in developing culturally responsive practices. A recent search on the Child Welfare Information Gateway resulted in numerous training programs and modules nationwide covering a wide range of child welfare challenges to assure culture is recog- nized as an important part of the service delivery process (www. childwelfare. gov/systemwide/cultural/staff.cfm). Training in cultural competence included content focused on the primary racial and eth- nic groups identified by the U.S. Census (African American, Latino, various Native American tribal communities, and Asian Americans), immigrant communities, and multicultural populations.

A cultural competence framework challenges workers to develop practice knowledge and skills for working across cultures and with respect to cultural and linguistic differences. Essential elements of cultural competence include valuing diversity, developing cultural self-awareness, appreciating the dynamics of cross-cultural interac- tions, being knowledgeable about within-group cultural differences, and demonstrating an ability to develop service delivery that is rele- vant and responsive to the diverse and complex needs of the individ- uals, families, social networks, and communities (Fong & Furuto, 2001; Gallegos, Tindall, & Gallegos, 2008; Lee, 2010; Lum, 2004; Lynch & Hanson, 1998; Nash & Velazquez, 2003; U.S. Department of Health and Human Services [USDHHS], 2001).

Drawing on Guba and Lincoln’s (1998) seminal work on episte- mological perspectives undergirding social sciences, Williams’ (2006) epistemological perspectives of cultural competence highlight differ- ent paradigmatic tools on which culturally competent practice can be

Vol. 90, No. 5Child Welfare

28

Acknowledgments: The UM-SSW Recruitment and Retention of Child Welfare Professionals Program wishes to acknowledge the contributions of the project team and Michigan Department of Human Services for their valuable feedback and support. This grant was supported by the U.S. Department of Human Services, Administration on Children, Youth, and Families, Discretionary Programs, Child Welfare Training Grant, Award #90CT0115.

based—postpositivism, constructivism, critical theory, and post- modernism. Among the critiques offered from Williams’ observation is the point that how people conceptualize culture matters for inter- vening to the extent that each epistemological perspective offers a different lens through which culture and practice with culturally diverse populations becomes operationalized.

Critiques of cultural competence models illuminate the many challenges to child welfare work. A cultural competence focus on racial and ethnic differences, for example, may convey misconceptions that racial and ethnic groups can be understood as a set of observable and predictable traits, thereby instilling a false sense of confidence in workers about their knowledge of culturally different individuals or families (Cohen, 2009; Dean, 2001; Furlong & Wight, 2011; Johnson & Munch, 2009; Lee, 2010; Tervalon & Murray-Garcia, 1998; Weaver, 1998; Williams, 2006; Yan, 2008; Yan & Wong, 2005). The many meanings of culture in terms of their social constructions, adap- tiveness, intergenerational transmission, and variations across time, generations, and sociopolitical contexts reflect the illusiveness of the boundedness of culture. Cultural experiences are best explained as an accumulation of social experiences that are maintained, accommo- dated or assimilated therefore culture ought to be viewed as having both stable and ever-changing aspects that may be revised as a con- sequence of interaction with others (Cohen, 2009; Dean, 2001; Fiske, 2002; Furlong & Wight, 2011; Gallardo, Johnson, Parham, & Carter, 2009; Johnson & Munch, 2009; Lee, 2010; Triandis, 2007; Weaver, 1998; Williams, 2006; Yan, 2008; Yan & Wong, 2005).

Coupled with the growth of increasingly diverse communities, their accompanying child welfare (and other) service challenges, and the high rates of child welfare worker turnover, these factors make expectations of cultural competence increasingly infeasible (Dean, 2001; Fiske, 2002; Furlong & Wight, 2011; Johnson & Munch, 2009; Korbin, 2002; Lee, 2010; Yan, 2008; Yan & Wong, 2005).

Critical race theory argues that a cultural competence perspec- tive typically fails to acknowledge the socio-structural mechanisms and institutional processes that prescribe and proscribe social injus- tices as a consequence of cultural differences when compared to

Child WelfareOrtega and Faller

29

mainstream, dominant society (Abrams & Moio, 2009; Adams, Bell, & Griffin, 1997; Casey Family Programs, 2000; Finn & Jacobson, 2003; Gopaul-McNicol, 1997; Green, 1999; Ivey & Collins, 2003; Korbin, 2002; Tervalon & Murray-Garcia, 1998; Yan, 2008). Sue et al.’s (Sue, Bucceri, Lin, Nadal, & Torino, 2009; Sue, Capodilupo, & Holder, 2008) concept of microaggressions appears relevant to the experiences of diverse populations in terms of both negative social experiences and the negative consequences in their search for help.

Cultural competence training has been argued to not go far enough in holding workers accountable for the privileged and power position their role entails. The expectation of cultural literacy among workers exacerbates the power imbalance between worker and client (Bogo, Tsang, & Lee, 2011; Furlong & Wight, 2011; Hernandez & McDowell, 2010; Yan, 2008). In the literature, a power dimension is used to explain how authority and control can be used to influence and affect worker decision-making and client choices. Power has been used to explain bias, prejudice, discrimination, sexism, ageism, racism, and so on that result in the poorest of the poor and particu- larly single parents, young caregivers, persons with mental illness, and older caregivers being denied or having limited access to resources and support (Finn & Jacobson, 2003; Hernandez & McDowell 2010; Roberts, 2002; Sengupta, 2006). Positions of privilege and power guards workers from uncovering the inextricable link between race, power, privilege, and racialized oppression and the social action called on to effect systemic (e.g., agency) change (Adams et al., 1997; Casey Family Programs, 2000; Caughy & Franzini, 2005; Center for an Urban Future, 1998; Coalition for Asian American Children and Families, 2001; Finn & Jacobson, 2003; Hernandez & McDowell, 2010; Ivey & Collins, 2003; Lee, 2011; Roberts, 2002; Velazquez et al., 2003). Ethical considerations, rights to self-determination, and the appropriateness of workers acting on behalf of clients with culturally different experiences from the worker’s cultural upbring- ing also become issues for concern (Gallardo et al., 2009; National Association of Social Workers, 2007, 2008; Yan, 2008).

As these critiques suggest, a cultural competence perspective, while applauded, is insufficient if the goal is to fully appreciate the

Vol. 90, No. 5Child Welfare

30

unique contribution each person, family, and community (inclusive of their unique cultural experiences) brings to the helping process. Ironically, the concept of cultural competence originated to pro- mote respect for cultural differences, yet may emphasize similari- ties at the expense of individual differences ( Johnson & Munch, 2009; Korbin, 2002; McPhatter, 1997; Velazquez, McPhatter, & Yang, 2003; Yan, 2008).

Moving Toward Cultural Humility Cultural humility training offers another perspective for child wel- fare workers to use to work effectively with families that are cultur- ally different from them (Tervalon & Murray-Garcia, 1998). This article emphasizes important concepts such as multiculturalism, inter- sectionality, and cultural humility as important threads that weave together a critical aspect of child welfare work—engaging families as active participants in maintaining a safe and permanent living environment that promotes child well-being (Korbin, 2002; Kossak, 2005; McPhatter, 1997; Sengupta, 2006; Velazquez, McPhatter, & Yang, 2003).

A multicultural perspective moves us away from viewing culture as monolithic. While the child welfare literature points out that “race” matters, and much controversy relates to the impact of race on child welfare service delivery, race is but one social identity (Center for an Urban Future, 1998; Elliot & Urquiza, 2006; Fluke, Yuan, Henderson, & Curtis, 2003; Futa, Hsu, & Hansen, 2001; Harris & Courtney, 2003; Hernandez & McDowell, 2010; Hill, 2006; Korbin & Spilsbury, 1999; Roberts, 2002). Multiculturalism, then, includes but is not limited to knowledge, beliefs, values, morals and customs, language, behaviors, and practices of a single cul- ture but more accurately reflects our experiences with more than one culture.

An intersectionality perspective asserts that people simultaneously occupy multiple positions (positionalities) within the socio-cultural- political and structural fabric of society (Crenshaw, 1995; Harris & Courtney, 2003; Hill Collins, 2000; Hernandez & McDowell, 2010).

Child WelfareOrtega and Faller

31

These positionalities intersect and result in different behavior, depend- ing on the social context. For example, people occupy social posi- tions and may respond differently depending on gender, religious beliefs, race and ethnicity, socioeconomic class, age, ability, gender identity, or sexual orientation. In child welfare, it is argued that inter- secting group memberships affect people’s expectations, quality of life, capacities as individuals and parents, and life chances.

A cultural humility approach advocates for incorporating multi- cultural and intersectional understanding and analyses to improve practice, since together these concepts draw attention to the diver- sity of the whole person, to power differences in relationships (espe- cially between workers and families), to different past and present life experiences including microaggressions, and to potential resources or gaps (Brown, 2009; Furlong & Wight, 2011; Gallegos et al., 2008; Kossak, 2005; Lee, 2010).

A cultural humility perspective draws on three dimensions essen- tial to connectedness with one’s self and others (Morris, Brotheridge, & Urbanski, 2005). First, cultural humility promotes self-awareness to the extent that people must appreciate who they are from a cul- tural perspective and how this shapes the lens through which they view the world. Narayan (1999) draws on the concept of “epistemic privilege” to bring attention to the fact that each person has an immediate, internally processed, and critical sense of who he or she is relative to experiences. People, in a sense, walk the mile in their own shoes and therefore are privileged to know themselves far more than can be expected of others. By engaging in a process of realistic, ongoing self-appraisal of biases and stereotypes, workers are encour- aged to assess the ways in which their own attitudes and behaviors prevent them from learning from their clients. Drawing solely on their own knowledge will not sustain new insights, awareness, and relevant behavioral change. Engaging in a process of self-awareness and self-reflection will ideally awaken the worker to the power imbalance of workers and clients that may influence their response to the services they provide.

A second dimension focuses on the characteristic of openness. Openness implies an appreciation of the fact that people do not and

Vol. 90, No. 5Child Welfare

32

cannot expect to know all there is to be known especially about the world, including the individuals with whom they interact. They must acknowledge the world that functions outside of awareness that may influence them in certain ways, consciously or unconsciously. Cultural humility in this regard is an acknowledgment that the experiences of others, outside of themselves, require them to be open to their expe- riences, from their perspective. In human services, it is an essential helping virtue to the extent that it requires them to learn from the people with whom they aim to help.

The third dimension relates to Morris et al. (2005) concept of transcendence. They write,

Transcendence can best be thought of as an acceptance of something greater than the self. Out of this acceptance comes an understanding of the small role that one plays in a vast uni- verse, an appreciation of others, and a recognition that others have a positive worth. (p. 1331)

A cultural humility perspective in the context of transcendence moti- vates people to consider the fact that in efforts to know themselves personally and professionally, as well as others in the helping context, people must embrace the reality that the world is far more complex and dynamic then perhaps they can imagine. People lend their expert- ise on the basis of what they know, and in the connections they make as part of their helping. In child welfare, the worker must draw on the cultural expertise of the families with whom they work and even then must recognize that the vastness of cultural experience likely exceeds their capacities to fully understand all that is to be known.

In sum, a cultural humility perspective encourages workers to take into account an individual’s multiple identities and the ways in which their social experiences impact their worldview, particularly as it relates to their expression of their culture. Demonstrating cul- tural humility frees workers from having to possess expert knowl- edge about an array of cultural differences. This perspective has the benefit of placing the worker in a learning mode as opposed to maintaining power, control, and authority in the working relation- ship, especially over cultural experiences about which the client is far more knowledgeable. Freeing child welfare workers from the

Child WelfareOrtega and Faller

33

expectation that they must possess knowledge about their clients’ cultural experiences is consistent with an important component of what the social justice literature refers to as “liberation of con- sciousness” (Ivey & Collins, 2003, p. 293). Workers become liber- ated from the constraints of cultural stereotypes and boundaried knowledge about specific cultures and are encouraged to learn from the families they serve about their experiences, both past and pres- ent, from the “others” perceptions of their experiences, and the meanings they apply to their experiences. Furlong and Wight (2011) argue for renaming cultural competence to “critical awareness” to move toward respecting an individual’s unique cultural experiences and internalized cultural meanings.

A cultural humility perspective encourages a less deterministic, less authoritative approach to understanding cultural differences, placing more value on the child and family’s own cultural expressions as they relate to their situation (Tervalon & Murray-Garcia, 1998). The worker relinquishes the role of expert to the client and instead becomes a learner who supports the client’s role of being a capable, contributing partner to the service delivery alliance. Cultural humil- ity is a child- and family-focused approach to service, beginning with the initial report and investigation. Child welfare workers must never lose sight of their responsibilities for child safety, permanency, and well-being (Adams et al., 1997; Ivey & Collins, 2003; McPhatter, 1997; Velazquez et al., 2003; Weaver, 1998), but they also should work in a non-paternalistic and respectful way with families.

Much of what a cultural humility perspective offers is consistent with traditional social work practice (Anderson & Goolishian, 1992; Furlong & Wight, 2011; Hepworth, Rooney, Rooney, Stom- Gottfried, & Larsen, 2010; Kossak, 2005; Lee, 2010; Ross-Sheriff, 2008; Yan & Wong, 2005). Starting where the client is, learning from the families, and demonstrating empathy are all important aspects of cultural humility practice, but not sufficient. Cultural humility pro- motes practice skills and techniques that support culturally appro- priate interaction designed to reduce the worker’s need to master the wide range of different cultures and enable clients to describe their view of problems. Cultural humility moves people deeper into an

Vol. 90, No. 5Child Welfare

34

honest appraisal of cultural knowledge and awareness and diminishes the illusion that professional expertise includes expertise of the cul- tural knowledge and experiences of the client that help to define them (and their actions) in the present.

A cultural humility perspective must also be considered an ongo- ing process rather than outcome (Tervalon & Murray-Garcia, 1998). It involves a worker’s commitment and active engagement in the process of mutual understanding and awareness of self in relation- ship to others. Workers must become continuously sensitized to fac- tors at play in defining important priorities and activities needed to achieve personal and family well-being. Child welfare workers are challenged to identify, understand, and build on assets and adaptive strengths of children and parents and perhaps engage in efforts to change the kind of social forces that act to disempower them as mem- bers of society.

Cultural humility should include an assessment of the organiza- tional environment, policies, procedures, knowledge, and skills con- nected to worker practices (Child Welfare League of America, 2002; Tervalon & Murray-Garcia, 1998; Vera & Rodriguez-Lopez, 2004). Efforts must be made to identify ways in which a cultural humility perspective can be embraced and promoted. Likewise, effort must be made to uncover barriers and obstacles within the organization that inhibit a cultural humility approach. Written plans, training, and organizational support are called on that hold the organization accountable to the diverse make up and needs of the community being served.

Crossing Cultural Boundaries and Bridging Cultural Perspectives The authors depict the interacting space between the client and worker in a manner consistent with Lee’s (2010) notion of the “area of therapeutic interaction” (p. 276). Figure 1 depicts two separate circles interacting within larger concentric circles. The extreme outer circle represents the boundaries of the society people share; in which people all live, affirm, and reinforce their own familiar cultural

Child WelfareOrtega and Faller

35

experiences. In this societal space, they also encounter new cultural experiences that they may ignore, accommodate, or assimilate.

As members of specific communities and working within the child welfare system, represented by the inner circles, the child wel- fare worker is held to the responsibility of assuring child safety and permanence, and well-being. As representatives of the child welfare system, workers are educated and trained according to policies, pro- cedures, and practices that guide their professional actions. Inter - actions between the worker and client must take into account each other’s “positionality” and power/authority differences. Explicit (and implicit) interactions between the worker and client, located in the extreme inner circle of the figure, require some appreciation of the differing power, authority, and positionalities that each hold. A cul- tural humility perspective draws attention to this interacting space, both figuratively and literally, in which bridging differences occurs.

Vol. 90, No. 5Child Welfare

36

Figure 1 Bridging Perspectives

Both the child welfare worker and the client bring their history and cultural experiences to their interactions. Each views the encounter through his or her own lens or worldview. What they share as a common purpose is a concern about the well-being of the child. It is the responsibility of the child welfare worker to bridge their differ- ing perspectives.

The authors have identified some essential worker skills for bridg- ing perspectives. They are defined next along with examples of their application.

Skills for Bridging Perspectives In demonstrating cultural humility, the authors point to at least four essential skills: active listening, reflecting, reserving judgment, and entering the client’s world. Each of these skills finds support in the social work practice literature although the authors think they are especially important in demonstrating cultural humility. What follows is a description of these skills in the context of a cultural humility perspective followed by case examples that illustrate their importance.

Active Listening Active listening is the tangible feedback that indicates to the client that a person is, indeed, listening (Hepworth et al., 2010). Active lis- tening focuses attention on to what the person is saying using head nods and utterances, such as Rogerian “umhum,” “I see,” and “okay,” that indicate the worker is attending to the client. Repeating state- ments and offering equivalent reflections of the person’s narrative is especially relevant from a cultural humility perspective.

Case Example—Sherry Sherry is a young, single, African American mother who dropped out of high school, works in fast-food restaurants, and continuously finds herself and her three children in homeless shelters due to her unstable income. Protective services removed her children from her custody while living in a shelter because they were unsupervised, even though Sherry was in another location in the shelter trying to

Child WelfareOrtega and Faller

37

arrange job interviews while her oldest child, age 9, watched the two younger, preschool aged children. In an interview with a worker, Sherry described with intense frustration the removal of her chil- dren, the court process, and placement of her children into a white foster home in a separate county approximately 15 miles away. She was incensed that the judge asked her about her children’s fathers— men who had never provided support—in an effort to assess their ability to support the children. She complained vociferously about the fact that at a recent foster home visit one of her children had blisters on his toes from wearing shoes that were too small. Although the foster care worker could have focused on Sherry’s neglect of her children and what was needed to get them back, and considered Sherry’s blaming the system as avoidance of her own responsibility, the worker did not. Instead the worker listened intently, nodding and saying, “This sounds very upsetting to you, especially the assumptions being made about your own parenting.” Sherry became even more animated and talked about her own childhood and how hard she was trying to make her own children’s lives better than her own. The worker could see the situation from Sherry’s perspective, a single disempowered mother, limited to minimum wage jobs because of race, class, education, and gender, and struggling to provide shel- ter, food, clothing, and child care for her three children. The foster care worker could genuinely understand why Sherry was upset and used active listening skills to demonstrate her willingness to hear Sherry’s story from Sherry’s perspective.

Reflecting Active listening and reflective listening are sometimes used inter- changeably. From the authors’ perspective, reflecting deserves special consideration because they want workers to appreciate the two sep- arate issues relevant to reflection. First, reflection challenges the workers to demonstrate that their understanding of what is being said is consistent with the meaning intended by the client. It is not a sim- ple matter of repeating or summarizing the words of the client. Reflecting is a search for the meaning of what is being said by the client; it requires an openness that allows what is being said by the

Vol. 90, No. 5Child Welfare

38

client to be heard and appreciated. The second aspect of reflection rests with the client him- or herself. A metaphor for reflecting is a mirror. The mirror reflects not what is in the mind of the worker—it is a reflection back to the client of what the client has said. This sec- ond component is critical—it challenges the worker to hear what is meant from the client’s perspective. Cultural humility on the part of the worker encourages the worker to do their very best to “hold the mirror up” with the understanding that the lens through which the client views (and speaks about or represents in nonverbal ways) their world is uniquely their own.

Case Example: Jung Jung, is an Asian American father of two boys, ages 8 and 6. He and his non-Asian wife are in the process of divorce. The boys’ mother took the boys and fled from her husband to the local domestic vio- lence shelter. She told shelter staff that her husband not only ter- rorized her sons but was violent with her. The boys also exhibited a lot of sexual behavior problems in the shelter, exposing themselves, and touching each other’s privates. The shelter filed a report with child protective services. The protective services worker interviewed the boys and the mother at the shelter. The sons accused their father of physical and sexual abuse, but provided few and inconsistent details about their abuse. They clearly evidenced a great deal of fear of their father. The eight year old spontaneously described a time when his father hit his mother with a lamp and cut her forehead.

The protective services worker is now interviewing the father. The worker asks about any violence in the parental relationship. Jung said that his wife and he mostly had verbal fights—about three a day. Jung then asserted his wife was violent toward him, but he was never violent toward her. He said that one time she hit him in the head with a lamp and slapped him several times. He stated that his 8-year- old son observed his mother hit him with a lamp.

Resisting the natural inclination to respond with the son’s version, the worker reflected back, by saying, “You said she was violent toward you and hit you with a lamp and then she slapped you.” Jung vigor- ously affirmed this version of events and became teary-eyed. The

Child WelfareOrtega and Faller

39

worker then followed up with, “This seems upsetting to you; let’s pause for a moment and talk about that. . . .” Jung immediately began to talk about the impact his marital discord had on his relationship with his own parents, and he also had imagined raising his sons to carry on important cultural traditions, including language. To him it was the cumulative loss of family, loss of dignity, and the respon- sibility he assumed in carrying on cultural traditions. He acknowl- edged the firmness in which he parented his sons and maintained his role as head of the household but vociferously denied allegations of sexual abuse.

It is perhaps more challenging to try to bridge perspectives with a parent accused of domestic violence, physical, and sexual abuse, but the worker needed to obtain all perspectives. The worker is challenged to seek Jung’s view of his world—especially his cultural world—to assess his current situation including his perception of himself as husband and parent, and his perception of how others might view his situation.

Reserving Judgment Reserving judgment requires a conscious effort to listen intently on what is being said, appreciating the content while withholding the application of values judgments or beliefs that may compete with the values and beliefs of the client. Being judgmental would include prematurely reaching conclusions, letting one’s mind wander to his or her own perceptions as he or she applies the client’s expressed con- cerns to one’s own life or professional training, making assumptions about blame or fault, or applying information obtained elsewhere (e.g., case records) as the frame of reference on which to judge the accuracy of what the client is saying. Reserving judgment requires a conscious effort to remain open to the perspective of the other with an acute awareness of one’s own potential biases.

Case Example: Mark Mark, a 6-year-old African American boy, whose parents were both professionals, reported when interviewed at school that his father had “put clampers on his arms” (squeezed him so tight that he had

Vol. 90, No. 5Child Welfare

40

bruises—which the protective services worker could see and pho- tographed), hit him on his back (again there were a couple of bruises the worker photographed), repeatedly put his penis in his “butt,” “smeared poop” on him, and made him “eat poop.” The first two asser- tions were consistent with the boy’s physical condition, and Mark could describe in detail circumstances surrounding the physical abuse. Regarding the latter allegations, the worker wondered if Mark was embellishing the extent of his abuse, especially given Mark’s matter- of-fact presentation of these allegations and difficulty in detailing their occurrence. Rather than challenging Mark’s assertions, the worker remained silent and considered multiple hypotheses that might explain his allegations. The hypotheses for the statements about the physical and sexual abuse included (1) that all the allega- tions were a reality, (2) that these allegations combined reality and distortions related to trauma, and (3) that they are a distortion, with the harshness of the described behaviors having cultural implications. This boy appeared desperate for help; he needed a response from a worker who did not prematurely reject the boy’s report. Reserving judgment allowed the worker to consider many factors to account for the allegations, including cultural considerations.

Enter the Client’s World Sometimes referred to as “joining” (Minuchin, 1974), the child wel- fare worker is challenged to place him- or herself in the context of the client’s world (and as part of their culture and cultural experi- ence), accommodating to the cultural style of the client, experienc- ing to the best of their ability the client’s own cultural view as an “insider.” More so than that, in child welfare, the authors advocate for workers to consider the diverse challenges and strengths the client brings to the helping setting. By entering the client’s world, the worker is challenged to experience it from the perspective of the client without physically, psychologically, or emotionally retreating.

Case Example: Winona Family The family of Winona, a Native American mother, is involved in both the delinquency system and child protective services. One of her five

Child WelfareOrtega and Faller

41

sons, Trice, age 14, with a history of minor delinquent acts, has admitted to sexually molesting a 4-year-old half-sister. Winona’s recent reconnection with her Native heritage had given her a new perspective on life. She wanted Trice’s treatment to incorporate Native American traditional healing methods. The dilemma was that the Native American agency that offered traditional healing did not have expertise in adolescent sex offender treatment, although they had two therapists who had attended Making Medicine, an adapta- tion of trauma-focused cognitive behavior therapy (for sexual abuse victims) that incorporates traditional Native healing and rituals. The child protection and delinquency worker spent two hours listening to Winona describe her journey to tribal reconnection that included her own recovery in a Native American substance abuse treatment program. The worker listened to Trices’ descriptions of his participa- tion in powwows, following the seven grandfather’s gifts, and his trip back to his mother’s reservation. The worker came to the conclusion that traditional native healing and supporting Trice’s connection to cultural role models would be important for the family, perhaps diverting him from a delinquency pathway. They recommended to the court a coordinated combination of treatment and services from the Native American agency and adolescent sex offender treatment, which was approved.

Although these essential skills for bridging worker and client perspectives are described as separate and discrete, they are integrated action steps for approaching clients from a cultural humility per- spective. Workers can apply these skills to form working alliances with clients and provide more culturally relevant and sensitive serv- ices while promoting child safety, permanency, and well-being.

Summary and Practice Implications This article briefly discusses the rationale for the cultural humility training provided to child welfare workers. The authors believe the concepts, multiculturalism, intersectionality, and cultural humility should be incorporated in child welfare worker training and practice. The authors agree with the perspective in child welfare that reinforces

Vol. 90, No. 5Child Welfare

42

placing an emphasis on culture in all aspects of child welfare work. Institutionalizing training that draws attention to cultural difference means that the child welfare system fully appreciates the relation- ship between culture, parenting, and family well-being. A cultural humility perspective draws attention to the fact that an appreciation of culture is beyond what can be accomplished by cultural compe- tence alone. It is a call to recognize the uniqueness of each individ- ual involved in delivering child welfare services. It defines a place for the children and families, themselves, to become an integral part of the service delivery process with recognition of their unique and individual definitions of self and place in society. It is, furthermore, a call for workers to lend expertise about culture to the clients who are in the best position to define for themselves the meaning of their culture and cultural experiences.

The authors present the following practice principles as derived from key aspects of a cultural humility approach:

1. Embrace the complexity of diversity. In day-to-day existence, people occupy multiple positions with related identities and statuses. These identities operate together (intersect), to dis- tinguish people as individuals. Intersecting group member- ships affect people’s expectations, quality of life, capacities as individuals and parents, life chances, and so on. They draw attention to the whole person, power differences in rela- tionships, different past and present experiences based on positionalities and social contexts, and potential resources (or gaps).

2. “Know thyself ” and critically challenge one’s “openness” to learn from others. Child welfare workers are urged to engage in a process of realistic, ongoing self-appraisal of cultural experi- ences and biases and stereotypes about self and self in rela- tionship to other cultures. Workers must assess the barriers their own attitudes and behaviors present to learning from others about others since personal knowledge alone will not sustain new insights, awareness, and behavioral change.

3. Accept cultural difference and relate to children and families in ways that are most understandable to them. Cultural

Child WelfareOrtega and Faller

43

humility encourages a less deterministic, less authoritative approach to understanding cultural differences, placing more value on the child and family’s own cultural expressions of concern and perspective. Communication skills and cultur- ally appropriate interaction techniques are expected to reflect the clients’ unique experiences, thus reducing the worker’s need to master completely the wide range of cultural beliefs and practices.

4. Continuously engage in collaborative helping. Worker involve- ment must be considered an ongoing process rather than out- come. In addition, workers must be involved in mutually beneficial, non-paternalistic and respectful working relation- ships with families, and become sensitized to factors at play in defining important priorities and activities needed to achieve child and family safety, stability, and well-being.

5. Demonstrate familiarity with the living environment of chil- dren and families being served. Child welfare workers are challenged to learn to identify, understand, and build on assets and adaptive strengths of children and parents and perhaps engage in efforts to disrupt or dismantle the kind of social forces that act to disenfranchise and disempower them as members of society.

6. Build organizational support that demonstrates cultural humility as an important and ongoing aspect of the work itself. Cultural humility should include an assessment of the orga- nizational environment, policies, procedures, knowledge, and skills connected to worker practices. Effort must be made to identify ways in which a cultural humility perspective is embraced and promoted. Likewise, effort must be made to uncover barriers and obstacles within the organization that inhibit a cultural humility approach.

The most serious breech to culturally responsive practice is not so much the lack of knowledge of the details of any given culture, but the worker’s inability or unwillingness to develop self-awareness and a respectful attitude toward diverse and multiple points of view. It is the failure to take into account the cultural expertise of others, about

Vol. 90, No. 5Child Welfare

44

themselves, that ought to raise concern about our presumptions of cultural competence. Cultural humility requires attitudes, beliefs and actions that invite new information and new perspectives on an ongoing basis. It invites an acceptance of “not knowing,” and the wide range of cultural lenses that guide, sustain and reinforce our uniqueness. Through collaborative helping, it promotes a shared responsibility for understanding child welfare concerns and for the mutual discovery of effective change that supports cultural familiar- ity and that leads to child welfare’s mission of safety, permanence, and well-being.

References

Abrams, L. S., & Moio, J. A. (2009). Critical race theory and the cultural competence dilemma in social work education. Journal of Social Work Education, 45(2), 245–259.

Adams, M., Bell, L., & Griffin, P. (Ed.). (1997). Teaching for diversity and social justice: A source- book. New York: Routledge.

Anderson, H., & Goolishian, H. (1992). The client is the expert: A not-knowing approach to therapy. In S. McNamee & K. Bergen (Eds.), Therapy as social construction (pp. 25–39). Newbury Park, CA: Sage.

Bogo, M., Tsang, A., & Lee, E. (2011). Cross-cultural clinical social work practice. In J. R. Brandall (Ed.), Theory and practice in clinical social work (pp. 693–715). Thousand Oaks, CA: Sage.

Brown, L. S. (2009). Cultural competence: A new way of thinking about integration in ther- apy. Journal of Psychotherapy Integration, 19(4), 340–353.

Casey Family Programs. (2000). A conceptual framework of identity formation in a society of multiple cultures: Applying theory to practice. Seattle: Author.

Caughy, M. O., & Franzini, L. (2005). Neighborhood correlates of cultural differences in per- ceived effectiveness of parental disciplinary tactics. Parenting, Science, and Practice, 5(2), 119–151.

Center for an Urban Future. (Spring/Summer 1998). Race, bias, and power in child welfare. Child Welfare Watch, 1, 5.

Child WelfareOrtega and Faller

45

Child Welfare League of America. (2002). Cultural competence agency self-assessment instru- ment (Rev. ed.). Washington, DC: Author.

Coalition for Asian American Children and Families. (2001). Crossing the divide: Asian American families and the child welfare system. New York: Author.

Cohen, A. (2009). Many forms of culture. American Psychologist, 64(3), 194–204.

Crenshaw, K. W. (1995). The intersection of race and gender. In K. Crenshaw, N. Gotanda, G. Peller, & K. Thomas (Eds.), Critical race theory (pp. 357–383). New York: The New Press.

Dean, R. G. (2001). The myths of cross-cultural competence. Families in Society, 82(6), 623–630.

Elliot, K., & Urquiza, A. (2006). Ethnicity, culture, and child maltreatment. Journal of Social Issues, 62(4), 787–809.

Finn, J. L., & Jacobson, M. (2003). Just practice: A social justice approach to social work. Peosta, IA: Eddie Bower Publishing.

Fiske, A. P. (2002). Using individualism and collectivism to compare cultures—A critique of the validity and measurement of the constructs; Comment on Oyserman, et al. (2002). Psychological Bulletin, 128, 78–88.

Fluke, J. D., Yuan, Y. Y. T., Hedderson, J., & Curtis, P. A. (May/June 2003). Disproportionate representation of race and ethnicity in child maltreatment: Investigation and victimiza- tion. Children and Youth Services Review, 25(5/6), 359–373.

Fong, R., & Furuto, S. (Eds.). (2001). Culturally competent practice: Skills, interventions, and evaluations. Boston: Allyn and Bacon.

Furlong, M., & Wight, J. (2011). Promoting “critical awareness” and critiquing “cultural com- petence”: Towards disrupting received professional knowledge. Australian Social Work, 64(1), 38–54.

Futa, K. T., Hsu, E., & Hansen, D. J. (2001). Child sexual abuse in Asian American families: An examination of cultural factors that influence prevalence, identification, and treatment. Clinical Psychology: Science and Practice, 8, 189–209.

Gallardo, M. E., Johnson, J., Parham, T. A., & Carter, J. A. (2009). Ethics and multicultural- ism: Advancing cultural and clinical responsiveness. Professional Psychology: Research and Practice, 40(5), 425–435.

Vol. 90, No. 5Child Welfare

46

Gallegos, J. S., Tindall, C., & Gallegos, S. A. (2008). The need for the advancement in con- ceptualization of cultural competence. Advances in Social Work, 9(1), 51–62.

Gopaul-McNicol, S. A. (1997). A multicultural/multimodal/multisystems approach to working with culturally different families. West Port, CT: Praegar Publishers.

Green, J. W. (1999). Cultural awareness in the human services: A multi-ethnic approach. Needham Heights, MA: Allyn and Bacon.

Guba, E. G., & Lincoln, Y. S. (1998). Competing paradigms in qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), The landscape of qualitative research (pp. 195–220). Thousand Oaks, CA: Sage.

Harris, M. S., & Courtney, M. E. (May/June 2003). The interaction of race, ethnicity, and family structure with respect to the timing of family reunification. Children and Youth Services Review, 25(5/6), 409–429.

Hepworth, D., Rooney, R., Rooney, G., Strom-Gottfried, K., & Larsen, J. (2010). Direct social work practice, theory and skills (8th ed.). Belmont, CA: Thomson Brooks/Cole.

Hernandez, P., & McDowell, T. (2010). Intersectionality, power, and relational safety in con- text: Key concepts in clinical supervision. Training and Education in Professional Psychology, 4(1), 29–35.

Hill, R. (2006). Synthesis of research on disproportionality in child welfare: An update. Casey CSSP Alliance for Racial Equity in the Child Welfare System Report. Retrieved October 5, 2011, from www.aecf.org/�/media/Pubs/Topics/Child Welfare Permanence/Other/ SynthesisofResearchonDisproportionalityinChil/CW3622H1148.pdf.

Hill Collins, P. (2000). Black feminist thought: Knowledge, consciousness, and the politics of empowerment (2nd ed.). New York: Routledge.

Ivey, A. E., & Collins, N. M. (2003). Social justice: A long term challenge for counseling psy- chology. The Counseling Psychologist, 31(3), 290–298.

Johnson, Y. M., & Munch, S. (2009). Fundamental contradictions in cultural competence. Social Work, 54(3), 220–231.

Korbin, J. E. (2002). Culture and child maltreatment: Cultural competence and beyond. Child Abuse and Neglect, 26, 637–644.

Korbin, J. E., & Spilsbury, J. C. (1999). Cultural competence and child neglect. In H. Dubowitz (Ed.), Neglected children: Research, practice, and policy (pp. 69–88). Thousand Oaks, CA: Sage.

Child WelfareOrtega and Faller

47

Kossak, S. N. (2005). Exploring the elements of culturally relevant service delivery. Families and Society, 86(2), 189–195.

Lee, E. (2010). Revisioning cultural competencies in clinical social work practice. Families in Society, 91(3), 272–279.

Lum, D. (2004). Cultural competence, practice stages and client systems: A case study approach. Belmont, CA: Thomson Brooks/Cole.

Lynch, E. W., & Hanson, M. J. (Eds.). (1998). Developing cross-cultural competence: A guide for working with children and their families (2nd ed.). Baltimore: Paul Brookes Publishing.

McPhatter, A. R. ( January/February 1997). Cultural competence in child welfare: What is it? How do we achieve it? What happens without it? Child Welfare, 76(1), 255–278.

Morris, J. A., Brotheridge, C. M., & Urbanski, J. C. (2005). Bringing humility to leader- ship: Antecedents and consequences of leader humility. Human Relations, 58(10), 1323– 1350.

Minuchin, S. (1974). Families and family therapy. Cambridge, MA: Harvard University Press.

Nash, K., & Velazquez, J., Jr. (2003). Cultural competence: A guide for human service agencies (Rev. ed.). Washington, DC: Child Welfare League America.

Narayan, U. (1999). Working together across differences. In B. Compton & B. Galaway (Eds.), Social work processes (6th ed., pp. 243–252). New York: Brooks/Cole.

National Association of Social Workers. (2007). The indicators for the achievement of the NASW standards for cultural competence in the social work profession. Washington, DC: Author.

National Association of Social Workers. (2008). Code of ethics of the NASW (Rev. ed.). Washington, DC: Author.

Roberts, D. (2002). Shattered bonds: The color of child welfare. New York: Basic Books/Civitas.

Ross-Sheriff, F. (2008). Aging and gender, feminist theory, and social work practice concerns. Affilia, 23(4), 309–311.

Sengupta, S. (2006). I/me/mine—Intersectional identities as negotiated minefields. Signs: Journal of Women, Culture and Society, 31(31), 629–639.

Sue, D., Bucceri, J., Lin, A. I., Nadal, K. L., & Torino, G. C. (2009). Racial microaggressions and the Asian American experience. Asian American Journal of Psychology, 1, 88–101.

Vol. 90, No. 5Child Welfare

48

Sue, D., Capodilupo, C. M., & Holder, A. M. B. (2008). Racial microaggressions in the life experience of black Americans. Professional Psychology: Research and Practice, 39, 329–336.

Tervalon, M., & Murray-Garcia, J. (1998) Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125.

Triandis, H. C. (2007). Culture and psychology: A history of the study of their relationships. In S. Kitayama & D. Cohen (Eds.), Handbook of cultural psychology (pp. 59–76). New York: Guildford.

U.S. Department of Health and Human Services. (2001). Cultural competence works: Using cultural competence to improve the quality of health care for diverse populations and add value to managed care arrangements. Merrifield, VA: Health Resources and Administration.

U.S. Department of Health and Human Services. (March 2009). A closer look. Retrieved July 22, 2011, from www.childwelfare.gov/pubs/acloserlook/culturalcompetency/cultural competency.pdf.

U.S. Department of Health and Human Services, Children’s Bureau’s Improving Child Welfare Outcomes Through Systems of Care. Retrieved July 22, 2011, from www.childwelfare.gov/ management/reform/soc/communicate/initiative/rfp.cfm.

Velazquez, J., Jr., McPhatter, A. R., & Yang, K. (Eds.). (March/April, 2003). Perspectives on cultural competence [Special issue]. Child Welfare Journal of Policy, Practice, and Program.

Vera, D., & Rodriguez-Lopez, A. (2004). Strategic virtues: Humility as a source of compet- itive advantage. Organizational Dynamics, 33(4), 393–408.

Weaver, H. N. (1998). Indigenous people in a multicultural society: Unique issues for human services. Social Work, 43(3), 203–211.

Williams, C. C. (2006). The epistemology of cultural competence. Families in Society, 87(2), 209–220.

Yan, M. C. (2008). Exploring cultural tensions in cross-cultural social work practice. Social Work, 53(4), 317–328.

Yan, M. C., & Wong, Y. L., (2005). Rethinking self-awareness in cultural competence: Toward a dialogic self in cross-cultural social work, Families in Society, 86(2), 181–188.

Child WelfareOrtega and Faller

49

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

View publication statsView publication stats