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Journal of Social Work Education

ISSN: 1043-7797 (Print) 2163-5811 (Online) Journal homepage: https://www.tandfonline.com/loi/uswe20

Reconceptualizing Culture in Social Work Practice and Education: A Dialectic and Uniqueness Awareness Approach

Luis R. Alvarez-Hernandez & Y. Joon Choi

To cite this article: Luis R. Alvarez-Hernandez & Y. Joon Choi (2017) Reconceptualizing Culture in Social Work Practice and Education: A Dialectic and Uniqueness Awareness Approach, Journal of Social Work Education, 53:3, 384-398, DOI: 10.1080/10437797.2016.1272511

To link to this article: https://doi.org/10.1080/10437797.2016.1272511

Published online: 01 Mar 2017.

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Reconceptualizing Culture in Social Work Practice and Education: A Dialectic and Uniqueness Awareness Approach Luis R. Alvarez-Hernandez and Y. Joon Choi

ABSTRACT This article examines the definitions and implementations of the concepts of culture and cultural competence in social work education and practice. We take a look at the history and evolution of diversity and cultural competence in the social work curriculum. This article also identifies four theories and models of cultural competence taught in social work educa- tion, and the strengths and limitations of each theory and model are discussed. A new approach to cultural competence, the Dialectic and Uniqueness Awareness Approach, considers the triadic relationship between the social worker, the client, and the interaction of both with a multiplicity of systems and experiences. Finally, the five main principles of this approach are discussed using a case example.

ARTICLE HISTORY Accepted: November 2015

The term culture has been defined by many scholars and researchers in multiple disciplines. Sociology, psychology, counseling, anthropology, and social work are just a few of the disciplines whose members are attempting to understand, define, and explain the concept. However, a con- sensus on a clear and definite meaning of culture has not been achieved even within each discipline. Hence, the field of social work has taught and implemented numerous cultural competence models in its practice and education.

Social work education, guided by the Council on Social Work Education (CSWE) and the National Association of Social Workers (NASW), has evolved in teaching multiple approaches to culture and cultural competence. In response to the need for a more comprehensive and holistic model, we have developed the dialectic and uniqueness awareness approach (DUAA), which takes into consideration the paradigm of diversity within diversity and the uniqueness of each individual served by social workers.

Reconceptualizing culture

Sociologists Riley and Smith (2009) address the etymology of the word culture. They state that “in its early uses in English, culture was associated with the ‘cultivation’ of animals and crops and with religious worship” (p. 37). They further explain,

From the sixteenth century until the nineteenth, the term began to be widely applied to the improvement of the individual human mind and personal manners through learning. This was a metaphorical extension of the idea of improving land and farming practices. (p. 37)

From a contemporary point of view, a variety of authors have also defined culture with a societal perspective. From a family counseling perspective, Thomas (1998) cites Falicov, stating that culture could be defined “as a set of shared worldviews, meanings, and adaptive behaviors derived from simultaneous membership and participation in a variety of contexts including language, age, gender, race, ethnicity, religion, socioeconomic status, education, and sexual orientation” (p. 24). This definition coincides with counseling scholars Chi-Ying Chung and

CONTACT Luis R. Alvarez-Hernandez [email protected] Grady Health System, Atlanta, GA 30335-3801. © 2017 Council on Social Work Education

JOURNAL OF SOCIAL WORK EDUCATION 2017, VOL. 53, NO. 3, 384–398 https://doi.org/10.1080/10437797.2016.1272511

Bemak (2002) regarding the premise that culture seems to be the umbrella from which world- views. Thus, culture is a tool that defines reality for those who belong to the culture. Within this reality or worldview, the individual’s purpose in life is defined, and properly sanctioned behavior in the group is prescribed (Chi-Ying Chung & Bemak, 2002). Sue defines worldview as the way individuals perceive their relationship to the world, for example, their relationship with nature, other people, animals, institutions, objects, the universe, religion, and so forth (as cited in Chi- Ying Chung & Bemak, 2002).

Most of the definitions of culture or worldview leave the reader with more questions than answers. Perhaps disparities among the different understandings of culture are rooted in the fact that many definitions include the terms race and ethnicity. In social work, the conceptual problem is heightened by the fact that the term culture itself is not clearly defined; it is sometimes used to signify ethnicity or national origin (Fellin, 2000).

So how can social work find a clear definition of culture? “A field so sensitive to the power of labels, which insists on ‘serving clients’ rather than ‘helping patients,’ is obviously aware of the perils of language and its uses” (Park, 2005, p. 15). How can social work’s terminology reflect an accurate meaning of the word culture? As a social work scholar, Park (2005) attempts to solve this paradigm through the lens of critical discourse analysis, which she reports is “a neo-Marxist turn to the study of discourse which examines language and its usages to understand their social and political import” (p. 11). According to Park,

no usage of language can ever be considered neutral, impartial, or a-political . . . the usage of the concept of culture in social work and the meanings social work assigns to “culture” are profoundly political, biased . . . Despite the ubiquity of its usage, however, neither the meaning nor the significance of the concept of culture has been sufficiently examined in social work. (pp. 12–13)

Once it is understood that a term’s definition cannot be isolated from its sociopolitical construc- tion and implications, social work can develop a more precise meaning of culture.

According to Allen, the borders and the contents of culture, in other words, are understood to be constructed rather than discovered (as cited in Park, 2005). There is a tendency in literature and in the field to use the term culture as an identifier for other people. Typically, culture can be found next to adjectives like colored, immigrants, and non-White. By labeling other people as cultured, the social worker fails to acknowledge his or her positioning as privileged. The conscious mind of practitioners may not perceive their position as such, which may be the reason social workers, in general terms, do not understand the power culture has in their discourse toward their clients. Park (2005) further explains this dynamic,

If culture, characterized as a kind of a personal and community resource, is of significance and relevance only to minority/unprivileged populations, then it must be understood also as a paradoxical measure of deficiency; that which marks one as being less than those without it, and simultaneously, that which one must strive to retain as a buffer against that very weighted differential. (p. 19)

Park (2005) appeals to the ideals of our society and to the schemata of the social worker. She highlights culture in this arithmetic as a marker for the periphery, a contradictory descriptor for a deficit, since to have culture, in this schema, is to be assigned a position subordinate to that of those inscribed to be without culture (p. 22).

As noted earlier, the term culture has an array of meanings and as a concept it could signify a multiplicity of ideals depending on the lens used to define it. We conclude that the word culture could be defined as the growth, development, and expressions of a client system’s worldview through an interaction with its biopsychosocial and spiritual environments. However, for the purpose of this article, we use the word while keeping in mind its multidimensional use. Although it is imperative that social workers in various positions reconsider the meaning of culture personally, in their interventions, in the systemic and sociopolitical arena, and in academia, it is also necessary to ponder the influence that social work education has on social work students and practitioners.

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Social work education and culture

What have social workers learned about culture? How are social work educators teaching culture to their students? The CSWE (2015) has created standards that establish what is taught in accredited schools. How social work educators teach and evaluate culture in their courses has been an ever changing process for the CSWE. However, how can culture be taught and measured? Perhaps a look at social work education’s history could be enlightening.

Significantly for the first time, the 1973 CSWE guidelines explicitly suggested that the curriculum should reflect knowledge of racial and ethnic minority groups (Jani, Pierce, Ortiz, & Sowbel, 2011). The addition of this guideline created race and ethnic-specific courses, mainly related to African Americans, which aimed to increase social workers’ knowledge of African American communities for those who did not identify as African American. This premise suggested that knowledge was the only aspect necessary to understand others.

Historically, cultural competence with diverse populations referred to individuals and groups from non-White racial, ethnic, or cultural origins (Abrams & Moio, 2009). With time, guidelines changed to include other populations that expanded the meaning of diversity. For example, Jani et al. (2011) mention the CSWE’s 1976 incorporation of women’s studies into social work education, which included “current knowledge about women and the contributions of women to society and the elimination of sex-biased stereotyping. This principle does not suggest the addition of separate discrete courses” (p. 288).

The CSWE then added in the 1980s other special populations and themes such as sexism, heterosexuality, ageism, ableism, cultural and social diversity, different language, ethnic minorities of color, age, religion, and sexual orientation (Abrams & Moio, 2009; Jani et al., 2011). Jani et al. (2011) also explain how in 2001, “three new characteristics were added—family structure, marital status, and national origin—once again reflecting prevailing sociocultural trends” (p. 290). The CSWE in 2001 acknowledged the importance of “the interlocking and complex nature of culture and personal identity” and in 2008 determined that “programs are now expected to educate students to recognize how diversity may influence assessment, intervention, and research” (as cited in Jani et al., 2011, p. 291).

The terms diversity and culture tend to be used interchangeably as can be seen in past CSWE guidelines. Then, are culture and diversity the same? Does social work treat both terms in the same way? The CSWE’s (2015) Educational Policy and Accreditation Standards (EPAS) makes the follow- ing clarification under Competency 2:

The dimensions of diversity are understood as the intersectionality of multiple factors including but not limited to age, class, color, culture, disability and ability, ethnicity, gender, gender identity and expression, immigration status, marital status, political ideology, race, religion/spirituality, sex, sexual orientation, and tribal sovereign status. (p. 4)

Hence, culture could be seen as a form of diversity according to the CSWE guidelines. Furthermore, according to Educational Policy 3.0—Diversity of the EPAS: “The program’s expecta- tion for diversity is reflected in its learning environment, which provides the context through which students learn about differences, to value and respect diversity, and develop a commitment to cultural humility” (p. 12). Although social work education is expected to simultaneously address the diversity of cultures and within cultures, the CSWE guidelines seem to emphasize the diversity of cultures.

Social work education has come a long way in the evolution of teaching content, strategies, and measurements of culture and diversity since the 1970s. Currently, under Educational Policy 4.0— Assessment of Student Learning Outcomes, the CSWE (2015) requires social work programs to address competence “as holistic, involving both performance and the knowledge, values, critical thinking, affective reactions, and exercise of judgment that inform performance” (p. 14). The ways social work programs integrate culture and diversity into their curricula can be summarized in a few

386 L. R. ALVAREZ-HERNANDEZ AND Y. J. CHOI

different ways. Some programs have a required stand-alone course that specifically addresses culture and diversity, whereas in some programs all the courses are expected to integrate culture and diversity. In addition, social work programs integrate culture and diversity through study abroad programs in which students learn how another culture approaches daily life and gain new perspec- tives on common issues by directly interacting with the locals as well as with culture-specific courses for racial and ethnic populations; women; immigrants; lesbian, gay, bisexual, and transgender individuals, and others.

After more than 40 years of transformation, social work education constantly reconsiders the meanings and importance of culture, whereas administrators of social work programs also continue to seek relevant teaching methods to integrate culture into courses offered. Without this constant homeostatic relationship between philosophical underpinnings, idealistic statements, and social reality, the discourse of culture in social work education will not be able to move from identifiers of oppression and power.

Culture-related models

Various culture-related models have been taught and used in social work education throughout the years, including but not limited to the Culture-Specific Model, Cross-Cultural Model, Self- Awareness Model, and Critical Race Theory (CRT). To introduce the DUAA, which was informed by the these four models, a review of these models and their strengths and limitations is in order. These models are closely aligned with the NASW (2015) Standards and Indicators for Cultural Competence in Social Work Practice.

Culture-specific model

The culture-specific model was one of the first steps taken by the profession to address and acknowledge diversity and culture in education and practice. The initiative was started to understand those oppressed in society, specifically, people of color and women. The ability of social work students to understand these populations and the social transformations of the time typified by the civil rights and women’s movements allowed them to gain insight regarding specific demands, needs, and strengths of the populations involved. The culture-specific model is closely related to the NASW (2015) standards, specifically Standard 3, Cross-Cultural Knowledge, which urges social workers to “possess and continue to develop specialized knowl- edge and understanding that is inclusive of, but not limited to, the history, traditions, values, family systems, and artistic expressions such as race and ethnicity; immigration and refugee status; tribal groups; religion and spirituality; sexual orientation; gender identity or expression; social class; and mental or physical abilities of various cultural groups” (p. 24). Social work educators have also strived to foster their students’ curiosity by engaging them in culture-specific activities that could provide an understanding of others’ worldviews (Boyle, Nackerud, & Kilpatrick, 1999; Nicotera & Kang, 2009; Nwachuku & Ivey, 1991; O’Neal, 2012). These efforts of focusing on culture have been also integrated into therapeutic interventions (Collins & Arthur, 2010; Smith, Domenech-Rodriguez, & Bernal, 2011). The culture-specific model, as a milestone in the social work profession, started to expand our perceptions of those served. However, some limitations to this model have been identified.

The culture-specific model, in a variety of situations, tends to overgeneralize groups as homo- geneous and could perpetuate stereotypes and biases. Another limitation to this approach is the use of cultural informants (or experts in the culture). These informants can be biased and should not be considered an absolute reflection of the culture. Moreover, the culture-specific model could overlook the diversity within diversity of multiple groups. For example, a culture-specific model could be difficult to implement with the immigrant population if we take into account that “about two of five Hispanics are foreign-born; the other side of that coin indicates that a majority are native-born U.S.

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citizens, many of whom identify with the broad category without connecting to roots in Latin America or Europe” (De Haymes & Kilty, 2007, p. 104). Hence, it is important to consider the diversity within and between groups and the multiple biopsychosocial-spiritual factors that influence individuals (Carballo-Diéguez, 1989; De Haymes & Kilty, 2007; Falicov, 2007; Price, 2012; Santiago- Rivera, 1995; Sue, 1990).

Cross-cultural model

The cross-cultural model is the attempt to understand and address differences in worldviews between the social worker and the client system served, which is linked to the NASW’s (2015) Standard 4, Cross-Cultural Skills. This standard instructs social workers to “use a broad range of skills (micro, mezzo, and macro) and techniques that demonstrate an understanding of and respect for the importance of culture in practice, policy, and research” (p. 28). Some examples of these are “broaching behaviors” (Day-Vines et al., 2007, p. 401), which include the counselor’s ability to consider the relationship of racial and cultural factors to the client’s presenting problem and the use of a multicultural genogram (Thomas, 1998) that explores diverse areas of culture. Moreover, Cayleff (1986) highlights the dynamics in the counseling room, including “beneficent treatment [which] ensures that the patient is not harmed through a disregard for his or her belief system and does, in fact, benefit from the counselor-client relationship” (p. 346). Cross-cultural interventions also consider the use of empathy for the cultural differences in this relationship. Chi-Ying Chung and Bemak (2002) state that “empathy means understanding others by entering their world” (p. 155). Thus, cultural empathy means the counselor understands and appreciates cultural differences in a way that expands the boundaries of traditional empathy (Chi-Ying Chung & Bemak, 2002, p. 157). Although these attempts account for the social worker’s intentions to consider diversity between them and their clients, gaps exist in this approach.

For instance, Ponterotto and Benesch (1988) state that focusing on culture could take away from the client’s humanity. Focusing on multiple factors that shape humanity and having sensitivity for those individual factors, rather than acknowledging an intersectionality of identities, may lead the professional to misinterpretations. In addition, Boyle and Springer (2001) make clear that “cultural diversity course content has not necessarily translated into cultural competence skills for work with diverse client populations [and that] cultural competence remains more of an abstract ideal than a measurable outcome of social work education” (p. 54). The cross-cultural model acknowledges the relevance of diversity among individuals; however, it does not account for a measurable and definite approach to diversity and culture.

Self-awareness model

Self-awareness usually involves activities that aid the social worker to start an inner-process of awareness of his or her biases and stereotypes. Self-awareness assists the social worker in ethical decision making by constantly challenging perceptions that could interfere with the social work values of respect and dignity of the individual. The self-awareness model is clearly indicated in the NASW’s (2015) Standard 2, Self Awareness, which instructs social workers to “demonstrate an appreciation of their own cultural identities and those of others” and “be aware of their own privilege and power” (p. 22). Chi-Ying Chung and Bemak (2002) contend that the challenge to achieve cultural empathy is also tangible in the process of self-exploration and self-awareness, and the challenge for counselors is to

differentiate their cultural self and their strong cultural biases from those of their clients. Counselors must first examine themselves and explore both how their culture influences them and the impact of personal values, beliefs, habits, behaviors, customs, and so forth. (p. 157)

388 L. R. ALVAREZ-HERNANDEZ AND Y. J. CHOI

Diverse research has been conducted in the field involving self-awareness instruments. Many of these instruments assist students and field instructors on identifying prejudice, power, biases, and discrimination in their lives and society (Armour, Bain, & Rubio, 2004; Colvin-Burque, Zugazaga, & Davis-Maye, 2007). Being aware of these terms is significantly relevant in social work practice; however, a critique regarding the self-awareness model was made by Walker and Staton (2000), who stated, “Affirmations of beliefs do not equate with knowledge or actual competence” (p. 256). Moreover, Abrams and Moio (2009) mention four main deficits or challenges of this model:

It lacks the specificity needed to attain any concrete learning or practice objective; it does not reach far enough in addressing systemic and institutionalized oppressions; student readiness, teacher preparation, and possible resistance from both; and curriculum may unintentionally reinforce a color-blind paradigm that teaches students to ignore racial differences. (pp. 247–250)

By exercising self-awareness practices, social workers should be able to better understand them- selves, but it should not be overextended to a measurement of knowledge regarding others. Likewise, self-awareness plays a part in the social workers’ ethical acknowledgment of difference between them and their clients but should not be considered a sole source of an absolute understanding of diversity.

CRT

CRT attempts to consider race as a social construction to analyze, deconstruct, and transform the relationship between race and power as well as to advocate for anti-essentialism and intersectionality (Abrams & Moio, 2009; Ortiz & Jani, 2010). CRT arose as a study of the law during the civil rights movement and developed into studying the relationship between individual dynamics and the macro system. In contemporary literature and academia, Berry and Stovall (2013) discuss CRT in the context of the tragedy of Trayvon Martin, an African American youth who was killed in 2012 by a White male. Barry and Stovall contend that Martin’s death highlights the racial assumptions of young Black male violence and seek to explore what it means for education and institutionalized racism. Freeman (2011) also used CRT as a tool to reflect on President Barack Obama’s personal history and its impact on modern politics and society, the African American identity, and on social work education. Freeman noted that the multidisciplinary approach of scholars regarding CRT expanded over time to include subfields such as “critical race feminism, Latino critical race studies, and Asian American critical race studies” (p. 183).

As in social work, Solórzano and Bernal contend that CRT is founded on a set of values that reflect a commitment to “social justice and offer a liberatory or transformative response to racial, gender, and class oppression” (as cited in Ortiz & Jani, 2010, p. 183). Therefore, CRT can be understood in the context of the NASW’s (2001) ethical standards pertaining to social workers’ ethical responsibilities to clients, especially Standard 1.05, Cultural Competence and Social Diversity, which states “Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, and mental or physical disability” p. 13). Furthermore, CRT is closely related to the NASW’s (2015) Standard 6, Empowerment and Advocacy, which states,

Social workers shall be aware of the impact of social systems, policies, practices, and programs on multicultural client populations, advocating for, with, and on behalf of multicultural clients and client populations whenever appropriate. Social workers should also participate in the development and implementation of policies and practices that empower and advocate for marginalized and oppressed populations. (p. 35)

CRT is a valuable model when addressing the institutional and systemic dynamics of power and oppression involving people of color. “However, CRT does not necessarily provide a clear road map for teaching all forms of oppression simultaneously” (Abrams & Moio, 2009, p. 257). Additionally, CRT “may reinforce racist notions of non-Whites’ intellectual inferiority by endorsing the use of

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storytelling over reason” (Freeman, 2011, p. 186). Finally, even though CRT provides the student and practitioner with a different perspective on culture, it tends to focus on macro dynamics. We believe that by understanding CRT’s focus on power, social workers could consider their relationship of power with their clients as a microcosm of the interactions of the client within the larger society and institutions. Furthermore, the social worker could be guided by CRT to identify the role of power regarding race, racism, and privilege in the helping relationship.

Culture-related models in social work education

These culture-related models are reflected in NASW (2015) standards, which inform social work practice behaviors. Premises from the culture-specific model, for example, could be seen under Standard 3, Cross-Cultural Knowledge, regarding the importance of acquiring specific knowledge about an individual’s culture. The cross-cultural model is addressed under Standard 4, Cross- Cultural Skills, by encouraging social workers to ponder cultural differences with their clients. Furthermore, the self-awareness model links to Standards 2, Self Awareness, with an invitation to the social worker to look introspectively for biases and personal beliefs. Finally, CRT values are reflected in Standard 6, Empowerment and Advocacy, by the use of the words oppression, power, and privilege.

The DUAA approach

Ander-Egg (1988) defines dialectic as a “thought process that is aware of itself and is expressed as antithetical statements that an overarching synthesis attempts to reduce” (p. 98). Hence, when a social worker faces a system (micro, mezzo, or macro) that he or she considers different, a variety of previously learned statements, rules, or schemata about that system come to mind. The social worker encounters a dialectic by being aware of these statements and finding a discrepancy between what has been learned and the reality of that specific system. However, sometimes the practitioner’s schema regarding the system prevails over the system’s uniqueness. For example, a social worker who does not identify as Latino interviews a Mexican American female who has decided to surrender parental rights of her two sons to the state and not to the grandmother of the children. The social worker may have learned in school that the Mexican culture values family highly and is confronted with a client who seems to have different values regarding family. The social worker’s schema about the Mexican culture may interfere with an individualized conceptualization of the client’s values, presenting problem, childhood history, coping mechanisms, formative influences, and other factors. Then what should the professional do? How does a social worker conceptualize and intervene with systems that are perceived as culturally different?

Uniqueness denotes a difference in someone’s characteristics and experiences. In social work, this uniqueness could be translated into the intersectionality of identities and especially diversity within diversity. On the other hand, societal mores and values tend to dictate the norm or baseline for people’s behaviors, thoughts, and appearances. Therefore, any deviance from that baseline could be considered immoral, unlawful, uncommon, or eccentric. Eccentricity, in general terms, appeals to the weird, abnormal, strange, and on some occasions, to the bizarre. Moreover, some personality disorders have been classified under an eccentric cluster of psychopathology according to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013). However, how could a social worker establish what is abnormal or bizarre for the systems served? Every individual should be treated as unique, as a system within a system, a separate but influential member of a larger community. Therefore, cultural competence in social work practice implies a “heightened consciousness of how clients experience their uniqueness and deal with their differences and similarities within a larger social context” (NASW, 2015, p. 10).

A new approach to cultural competence that is aware of a dialectic and considers a system’s uniqueness is imperative. Therefore, a newly proposed approach, the DUAA uses as its base

390 L. R. ALVAREZ-HERNANDEZ AND Y. J. CHOI

awareness of a dialectic and the individuals’ uniqueness and intersectionality of identities. The DUAA takes into account the professional’s willingness to learn as in the culture-specific model, to challenge personal biases and prejudice as in the self-awareness model, to validate individual unique experiences and identities and to individualize a system’s assessment and intervention as in the cross-cultural model, and to acknowledge that power is inherent in every relationship as established in the CRT model. The DUAA is not only a combination of the multiple models and approaches previously discussed but also incorporates the social worker’s behavior of self- reflection and ensures personalized assessments of the systems they serve. This approach is a holistic attempt to consider the triadic relationship between the social worker, the client, and the interaction of both with a multiplicity of systems and experiences. Table 1 illustrates DUAA’s core features shared by the reviewed models as well as DUAA’s additional contribution.

DUAA premises and case study

The DUAA has five main premises: openness of the social worker to learn about a client’s uniqueness, deconstruction of the social worker’s personal schemata, validation and respect of the client’s uniqueness, personalized assessment and intervention and the social worker’s acknowledg- ment of implicit power in all relationships. The following section presents the case of the Hernandez family and illustrates how the DUAA premises are used in the case.

Case study: The Hernandez family

Roberto, a 42-year-old Mexican-immigrant, and his wife, Constanza, a 40-year-old Salvadoran immigrant, live in rural Georgia with their U.S.-born children, Jonathan, age 15; Kate, age 6; and Mary, age 4. The Hernandez family has been living in rural Georgia for the past 16 years and mother and father have limited proficiency in English. The Hernandez family was visited by a social worker after a report of physical abuse by one of Jonathan’s teachers. The substantiated report of child abuse in the Hernandez’s home stated that Roberto and his son Jonathan engaged in a physical altercation, leaving Jonathan with bruises on his arm.

Ms. Jackson, the African American family preservation case manager from the Division of Family and Children Services assigned to this case, had the opportunity to interview every family member individually and as a system. As a result of these interviews, she learned that Jonathan has been absent from school without his parents knowing and has been noncompliant with his 9:00 p.m.

Table 1. Comparison of cultural competence models and the dialectic and uniqueness awareness approach.

Cultural Competence Models Similarities with DUAA DUAA Additional Contributions

Culture-specific model

Takes into account the professional’s willingness to learn

Suggests the social worker not only learns about the systems served, but from the systems, allowing awareness of dialectic in interventions

Self-awareness model

Challenges personal biases and prejudice Self-reflection is suggested as an intrinsic part of conceptualization and interventions instead of as a separate and independent step

Cross-cultural model

Validates an individual’s unique experiences and identities and individualizes a system’s assessment and intervention

Suggests that a system’s uniqueness is because of the complexity of an intersectionality of identities

Critical race theory

Acknowledges that power is inherent in every relationship

Suggests that power is not only a determinant to consider in macro settings or as an institutionalized oppressor but also an element in micro and mezzo social work interventions

Note. DUAA = dialectic and uniqueness awareness approach.

JOURNAL OF SOCIAL WORK EDUCATION 391

curfew. The previous week, Jonathan arrived home at 2:00 a.m., and his father was waiting for him. After an intense argument regarding the importance of respect and attending school, Jonathan pushed his father. This caused Roberto to grab Jonathan’s arm, leaving bruises. The Hernandez family has no previous history of violence, and the younger children stated they have never been subject to abuse. The social worker returned to her office facing the difficult task of assessing and conceptualizing the family dynamics to facilitate a family team meeting scheduled in a week.

Openness to learn

A juxtaposition of ideas cannot be identified, acknowledged, or challenged if the dialectic is not accepted by the social worker. As in the self-awareness model, the social worker should be aware of his or her own biases and beliefs and assume responsibility for his or her thoughts and feelings. The student or practitioner should ask, Is this what I think I know? Why should I open myself to learn from this system about who she or he is? How can my openness benefit my relationship with this system? Am I being unethical by not allowing myself to learn from this system? How do I feel or think about this system? Am I experiencing prejudices or biases about this system?

For example, with the Hernandez family, the social worker first thought of the preconceived idea that African Americans and Latinos have similar family values. Ms. Jackson then reconsidered her previous knowledge of the Latino population, thinking of the multiple identities of the family members. The mother was from El Salvador, the father was from Mexico, and the children were born in Georgia. The social worker acknowledged that obtaining more information from each family member could enlighten her understanding of the family dynamics. Clearly, there were at least three perceptions of discipline, freedom, and the value of school among the father, mother, and the oldest son. These multiplicities of perspectives could be attributed to assimilation, acculturation, sense of belonging, formative influences, developmental stages of each member, and generational values. Ms. Jackson decided that the most ethical and beneficial step to foster a healthy and open working relationship with the family would be to further discuss with each member his or her perception of the abuse and the precipitating factors that led to the incident.

Deconstruction of personal schemata

After the social worker is aware of the dialectic, he or she should ask, What do I think I know? What stereotypical beliefs do I have about this system? How are my schemata different from this system’s eccentricity? What is different about my schemata and the system’s schemata? The social worker could implement skills learned from a culture-specific model; however, the practitioner should learn from the system and not about the system. Moreover, the social worker should address the schemata of the absolute and overgeneralization. Then the practitioner should be able to deconstruct biases, prejudices, or erroneous information regarding an aspect or aspects of the system. The social worker could use empathy as a mode for creating a catharsis in this process by asking, What do others (or even my client) think of me based on stereotypes, and what would I like them to know instead? Hence, self-awareness could be a useful tool for this process.

The importance of deconstructing personal schemata comes from a point of action and imple- mentation. The previous culture-related models encourage introspection, knowledge, and acquiring skills. However, these elements are only a portion of the equation if not translated into action. Moreover, deconstructing personal schemata requires the social work practitioner and student to recognize the power of merging these elements and to translate them into behavior that leads to best and ethical practices. Said differently, deconstructing personal schemata recognizes that systems theory applies to the social worker in the sense that the combination of these elements is more than the sum of its parts. Deconstructing personal schemata acknowledges that a change in the social worker’s thoughts and behaviors implies a change in his or her practice and interventions.

392 L. R. ALVAREZ-HERNANDEZ AND Y. J. CHOI

After Ms. Jackson made the decision to personalize her knowledge of the Hernandez family members’ unique identities, she became aware of her own schemata regarding family violence and the value of education. The social worker realized her interview questions alluded to stereotypes regarding the Latino community (Are your parents documented? Do you have many family members that live close to you? Why don’t you have a close relationship with your family?). Ms. Jackson evaluated her initial thought of asking a Cuban friend about Latino family dynamics and determined she was overgeneralizing values and behaviors of Latino families. She also realized the Hernandez family was diverse even within family members, after she examined her knowledge and experience versus the family’s uniqueness.

Validation and respect of the client’s uniqueness

When the social worker has deconstructed schemata and accepted the system’s uniqueness, he or she will be able to validate and respect the client’s uniqueness. Moreover, by acknowledging the cross- cultural model approach the practitioner should identify differences and similarities between his or her culture, the client’s self-identified culture, and the diversity within diversity in cultures. Hence, the social worker could ask, What do I think those in the system would wish that I would recognize or understand about them instead? How do those in the system identify with history or parts of history (i.e., immigration, feminist movement, sociopolitical revolutions and dictatorships, civil rights movement, etc.)? Do the members of the system have a sense of belonging? If so, how is it manifested? Which significant experiences, if any, have shaped the worldviews of those in the system? Is there any individual or collective trauma history? What intersectionality of identities is present in this system? By addressing these factors, the social worker should understand, validate, and respect system members’ feelings, experiences, and uniqueness. Moreover, the social worker should consistently comply with the profession’s ethical premises and values of dignity and self- worth of an individual.

With the Hernandez family, Ms. Jackson had the opportunity to meet again with each family member individually and then better understood the situation. Furthermore, she validated and respected each family member’s perspectives and experiences. The social worker learned that Roberto was raised in Mexico by his father, who was the school superintendent for their district and taught Hernandez and his siblings the value of education. Roberto happened to be working as a dishwasher in the United States because he could not validate his Mexican engineering degree here. He also said his siblings were professionals in Mexico and that his oldest brother did not finish law school because of drug abuse and is currently missing. Roberto concluded he was a “proud working Mexican immigrant who wanted his son to finish school and avoid the fate of [his] brother.” Constanza, on the other hand, was raised in El Salvador and lived in Guatemala with an aunt for part of her teen years. She understood her husband’s position but also sympathized with her son’s frustration of being a misunderstood teenager in between cultures. Jonathan said his father “annoyed” him by identifying him as “Latino.” Jonathan stated, “I am a southern boy; I am neither Mexican nor Salvadoran.” The social worker was able to recognize that Jonathan spoke limited Spanish, most of his friends self-identified as White, and that he was not interested in school.

Personalized assessment and intervention

The social worker should abide by the ethical premise of self-determination when addressing this premise and should ensure that what has been learned from the client will translate into action. An understanding of the system’s uniqueness should be reflected in the practitioner’s interventions, treatment plans, suicidal and homicidal prevention plans, conceptualizations, development of ther- apeutic dynamics, use of theoretical orientations, and community empowerment techniques, among other social work dynamics. Hence, the social worker could ask, What unique characteristics of this

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system should be taken into account when conducting the meeting? What steps should I take to ensure a personalized assessment and intervention? What should be addressed in the case plan? It is important to constantly evaluate our clients’ unique experiences and schemata. This premise serves, not as an innovative practice standard, but as a reminder to the practitioner to incorporate the client’s uniqueness into practice.

Regarding the Hernandez family, the social worker and the family created a case plan that incorporated the unique worldviews of Jonathan and his parents. For example, Mr. and Mrs. Hernandez would spend more time getting to know Jonathan’s friends and would attend English classes, free of charge, on Saturdays at a community agency to facilitate their communication with Jonathan. Additionally, the family made a plan to dedicate time together to understand each other’s formative influences. Jonathan and his parents also would explore alternatives to traditional school- ing and become more engaged with Jonathan’s other interests to help foster support and guidance at home.

Acknowledgment of implicit power in relationships

Even if the social worker is open to learn, deconstruct personal schemata, validate and respect the system’s feelings and experiences, and ensure individuality when assessing and conceptualizing the client, he or she needs to consider the implicit power involved in every interpersonal and macro dynamic. As established by the CRT model, power can be seen between diverse demographics, in a variety of settings, and among multiple types of relationships. The social worker, being an inherent part of the macro system’s structure, inadvertently engages in a power dynamic between himself or herself and the client. For example, even though the social worker could be asking open-ended questions to learn and deconstruct schemata, he or she has the implicit power of asking the questions. In addition, the social worker often has implicit powers such as connections to other agencies, making and signing referrals, approving services or benefits, and determining the extent of the client-clinician relationship, among other things. A social worker’s best intentions will never dismiss or eradicate this inherent power in the relationship. He or she should then reconsider the first four premises of this approach and be open to learn about that power, deconstruct personal schemata regarding power, validate and respect the system’s feelings and experiences with power, and be aware of power when assessing and conceptualizing the client.

Finally, with the Hernandez family, Ms. Jackson understood her position of power while working with family members. For example, she was able to speak English and communicate with Jonathan better than with his parents. Ms. Jackson was knowledgeable about the community agency that provided English classes and wrote an e-mail to a friend of hers who happened to be one of the volunteer teachers. The social worker also had the power of deciding the number of meetings to be held between her and the family to better assess the situation. Finally, the social worker had the implicit power of being an American citizen, having the ability to relate as a minority, and being a representative of the U.S. government as a case manager. Therefore, when Ms. Jackson was aware of the Hernandez family’s feelings and experiences with power dynamics, she was able to explore, validate, and respect their perceptions of power in the client–social worker relationship. Moreover, Ms. Jackson was aware of the power dynamics between the family and the macro system and took into consideration the various forms of power and oppression when assessing and implementing interventions with the Hernandez family.

Discussion

The 2010 U.S. Census (U.S. Census Bureau, 2011) made evident the increasing diversity in the United States, and the Hernandez’s family is a concrete example of the multidimensions of diversity and culture that social workers witness today. Thus, the task of preparing social work students to work in an ever more diverse society is critical for social work educators. With the publication of the

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revised EPAS (CSWE, 2015), social work program administrators need to demonstrate their pro- gram’s commitment to diversity by creating a “learning environment, which provides the context through which students learn about differences, to value and respect diversity, and develop a commitment to cultural humility” (CSWE, 2015, p. 14). We believe that the DUAA can be an excellent tool in social work education to promote the diversity competencies called for by the revised EPAS.

In sum, DUAA is an approach that takes into account the social worker’s dialectic, the system’s eccentricity and uniqueness, and the cultural competence indicators established by the CSWE and the NASW. Merely teaching cross-cultural knowledge about the history, traditions, values, and family systems of major client groups is not sufficient to promote diversity competencies of social work students; neither is teaching only institutional arrangements of society and their impacts on marginalized populations. The DUAA acknowledges several culture-related models’ potential for promoting diversity competencies and incorporates these models into a framework that can be used in working with client systems. As in the case of the Hernandez’s family, social work clients have diverse formative influences, identities, language skills, cultural values, and worldviews. Using the DUAA allows recognition of the complex systems served. More than simply teaching social work students about different modalities to be used with different systems, the DUAA requires students to challenge stereotypes and prejudices that would arise at face value by using the system as an informant of its own reality.

In addition, as highlighted in the Hernandez case, social work students can learn to practice the ethical principles of self-determination, worth and dignity of the individual and family, empower- ment, and person-centered interventions through the DUAA. The Hernandez family was able to act on a plan that was tailored to their situation and based on their own uniqueness. The dialectic of the

Table 2. Self-awareness exploration worksheet: Questions social workers should ask about themselves.

Openness to Learn Why should others open themselves to learn from you about who you are? How can their openness benefit your relationship? Deconstruction of Personal Schemata What stereotypical beliefs could others have about you? What stereotypes toward yourself have you experienced in the past? Validation and Respect of the Client’s Uniqueness What do you wish others would recognize/understand about you instead? (Consider: your identification with parts of history, sense of belonging, significant experiences, individual or collective trauma, intersectionalities of identities)

Personalized Assessment and Intervention If you were receiving social work services (therapy, community organizing, etc.), how would you like your uniqueness to be taken into account?

Acknowledgment of Implicit Power in Relationships Could you provide an example of how you have experienced power in a relationship with one of the providers/professionals you have seen in the past as a client/patient/student?

Table 3. Worksheet for social workers when working with client systems.

Openness to Learn How do I feel or think about this system? Why should I open myself to learn from this system about who she or he is? How can my openness benefit my relationship with this system?

Deconstruction of Personal Schemata What stereotypical beliefs do I have about this system? How are my schemata different from this system’s eccentricity? How are my schemata different from this system’s schemata?

Validation and Respect of the Client’s Uniqueness As the social worker, what do you think the system would wish that you would recognize/understand about him or her instead? (Consider: immigration experiences, language barriers, sense of belonging, significant experiences, individual or collective trauma, acculturation, intersectionalities of identities)

Personalized Assessment and Intervention What unique characteristics of this system should be taken into account when conducting the meeting? As the social worker, what steps would you take to ensure a personalized assessment and intervention? What should be addressed in the case plan?

Acknowledgement of Implicit Power in Relationships As the social worker, what powers do you have over the system?

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social worker in the case study was addressed even when considering her implicit role of power in front of a family that identifies with a culture that continues to be oppressed by individuals, institutions, and policies. The DUAA encourages social work students to be competent, ethical, and client centered while providing client systems with tools needed to empower themselves and opportunities to build rapport in helping relationships.

Finally, although the DUAA is not prescriptive, it provides concrete templates social work educators can use with students, such as the Self-exploration Awareness Worksheet (see Table 2) and the DUAA Worksheet (see Table 3). Even after taking cultural diversity classes, many students wonder how to use what they learned in class when actually working with clients. The DUAA provides specific steps for social work students to consider when working with clients, and each step poses questions for social work students. We believe that the questions it poses and the types of student interaction with client systems it encourages can be understood as social work diversity competencies.

As illustrated in reviewing different models that informed the DUAA, the NASW (2015) established standards for cultural competence for social workers; however, “after extensive literature review, consultation, and financial constraints, it became apparent that the NCORED [National Committee of Racial and Ethnic Diversity] would be unable to design outcome statements that could serve as metrics for a variety of systems” (Simmons, Diaz, Jackson, & Takahashi, 2008, p. 7). Hence, unable to measure outcomes, cultural competence indicators were established “as an extension of the standards to provide additional guidance on the implementation and realization of culturally competent practice” (NASW, 2007, p. 7). The indicators assist the profession in creating an action plan to better assess cultural competence. The DUAA premises could be seen as overlapping with some of the indicators established by the NASW. Seemingly, the DUAA encounters similar limita- tions in regard to accurate and appropriate measurements that could validate and support the model. However, similar to the indicators, the DUAA provides social work students and practitioners with a list of actions to be taken as a result of the questions established at each step.

More specifically, the DUAA is about awareness and being inquisitive, which is reflected in the interventions with client systems. The DUAA Worksheet can be used as the stimulus, and how students’ perceptions and behaviors changed regarding a client system would demonstrate their diversity-competent practice behaviors. In other words, would students seek more information about a client system with the DUAA than they otherwise wouldn’t seek to know? Would their perceptions and conceptualizations about the client system change after using the DUAA, reflecting their understanding of each client system’s uniqueness? Would their interventions change after using the DUAA, reflecting more holistic thinking? To gauge if the DUAA ignites more holistic thinking about the client system that wouldn’t otherwise be considered by students, we suggest the following. The case of the Hernandez family is introduced to students who are then asked to develop goals and interventions with the family. Next, social work educators teach the premises of the DUAA. To gain an understanding of the DUAA and ponder the validity and relevance of each step, social work students complete these steps using the Self-exploration Awareness Worksheet. Social work educa- tors should inform students that the worksheet will not be collected to ease student discomfort with answering the questions honestly. After completing the worksheet, social work educators can initiate discussions to determine if the worksheet was difficult to complete for students, if the questions were fair and relevant to them, and what the exercise brought up for them. After the discussion, students complete the DUAA Worksheet, answering the questions under each DUAA premise, thinking of themselves as the social worker in the case. Students develop goals and interventions to be used with the Hernandez family. Finally, students are divided into groups to discuss whether their perceptions and conceptualizations about the client systems and the goals and interventions they developed with the family have changed after employing the DUAA premises. We believe that other cases with different dimensions of diversity, such as age, class, religion, disability and ability, and sexual orientation, can be used with social work students to estimate clinical outcome changes associated with the DUAA.

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The DUAA attempts to be a catalyst for new approaches and to provide a different perspective that encourages social work students not to be deterministic nor reductionist and to acknowledge individuality and uniqueness in a macro perspective. It addresses the continuing observations of the need for more effective methods for engaging social work students in practice behaviors that demonstrate diversity competencies.

Notes on contributors

Luis R. Alvarez-Hernandez is Dual Diagnosis Clinician at Grady Health System, Infectious Disease Program. Y. Joon Choi Assistant Professor and MSW/MDiv Program Coordinator at the University of Georgia, School of Social Work.

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