The development of cultural competency and the communication patterns that mental health therapists use to facilitate growth and healing when working with people from various ethnic groups, cultural orientations, and walks of life cannot be overestimated.

It is often helpful to begin with a definition of “culture”.  Culture is how one perceives and deals with the world from a foundation of linguistic and mental characteristics.  It is what influences your decision making, although you are not always aware of its salience.  Culture is one present that your parents gave you that you cannot give back (even if you wanted to).  To conceptualize this idea we need to ask people we are seeking to understand these three simple but powerful questions:

• Where were you born?
• When were you born?
• Into which house were you born?

Think about it!

Where you were born runs the gamut of early influences of the environment on your family system, the role that extended family played in your life, your neighborhood and whether or not you felt included or estranged, etc.

When were you born gives you a sense of intercultural influences predominant during that period, the political or economic system at work in your society, significant events that shaped your small world, etc.

Into which house were you born helps you understand your birth rank order and the implication it has on your personality, your social class and status in society, the family dynamics and its impact on your life, et.  Culture is in essence transmitted through your parents and significant people in your life.

A famous Dutch researcher on the topic of cross cultural communication by the name of Holfstede conducted a study and found that people’s cultural values are ingrained in them by the age of 12. Think about this: What language do you use to pray, especially if you are in crisis?  What language do you count in almost automatically?

The field of social psychology tells us that it takes microseconds to make judgments about others. We usually judge others by taking actions. We judge others by our intentions because we make assumptions about people’s intentions. We do not normally realize that it is happening and therefore, we need to train ourselves and take that extra step and ask ourselves: Is that an assumption? Or is it a fact? We need to be that kind of person if we aim at becoming culturally competent. Just like we trained ourselves to be empathic listeners, we trained ourselves to create alliance with our clients, and trained ourselves to practice all the wonderful counseling skills, we must train ourselves to stop making judgments about others. Ask yourself constantly: Do I have enough information to make a judgment about that person?

As we all know, a necessary prerequisite for a mental health therapist is the desire to learn since working with clients is embarking on a journey of self-exploration. To be successful, we need to be ready to learn about people and at the same time learn about ourselves as we learn about people. Cultural competency is a journey that never stops. It is a professional and personal journey. You may attend all kinds of cultural competency workshops out there, but if you are not the kind of person who has these qualities, an openness to learn about people and about yourself, it just won’t do it!

What happens during the professional encounter with another human being while in a therapy session? You need to recognize that those encounters hold sameness and difference. We need to pay attention to that complexity. So the question is how can you relate to the humanness that we all share as well as to that specificity in terms of culture? You need to know about that person’s culture, while acknowledging at the same time that it is broadly defined. You want to know how that person may identify with you and what is salient about that person’s culture. The purpose for this knowledge is not because you want to make some generalizations and say “ Ahaa, I know how this person is going to feel”, but because you need to formulate a hypothesis by understanding how he/she is going to express own distress, what are his/her coping mechanisms and what the individual uniqueness are. Those three spheres or combination of complexities are what makes us human beings.

For our purposes here, I have adapted Elsevier Geo Leadership Model of 2008 to our understanding of the development of cultural competency. I am suggesting here that there are seven key intercultural competencies that all mental health workers need to develop while performing their duties successfully within a multicultural setting. I will also provide some examples that contribute to our understanding of these competencies:

Capability: Intercultural expertise, and if not adequate, then a willingness to develop this knowledge. If an Asian client is seeking therapy, my job as a therapist is to understand the major dynamics at play in that culture through educating myself using multiple resources including books, films as well as the client.

Care: Balanced interest and value for client and organization or self that reflects respect and mutuality. My professional integrity dictates that I treat all clients walking through the door with care and respect irrespective of who is paying and who may be on pro bono basis.

Change: Flexibility in adapting to dynamic cultural environments. The forces of globalization and the rapid change in traditional societies is constantly defying many stereotypical images of women.

Communication: Engaged connection and interactions with diverse cultures. Pursue rather than avoid working with multicultural clients and keep your mind open to learning about each person’s uniqueness within their own cultural context.

Contrasts: Cultural differences in motivating people to change. In my work with females from traditional societies, I often use the identification process at work to prompt people to grow and change.

Consciousness: Self-awareness of own cultural background and bias. Being introspective and constantly bringing up to the surface deeply held beliefs and cultural biases helps in raising one’s state of consciousness.

Context: Situational perspective with no judgment. Keep in mind that what you may judge as cultural dynamics may very well be more a situational consequence. A woman who is highly educated but not actively engaged in productive work may have a sick person to take of or some other situational factor at work.

Finally, here are some reminders on your journey of cultural competency development.

• We need to “Check Our Own Pulse” and become aware of personal attitudes, beliefs, and behaviors that may influence (consciously or unconsciously) our work as helping professionals as well as interactions with colleagues and staff from diverse racial, ethnic, and socio-cultural backgrounds.
• Every encounter with a care recipient is a cross cultural encounter. Developing partnerships with people experiencing different mental states and maintaining “cultural humility” can help us to learn and better understand the social and environmental contexts in their lives.
• There is no “one” way to provide mental health services. Given the great socio-cultural diversity within our world today, we need instead to have a framework of interventions that can be individualized and applied in a client-centered manner.
• We need to be flexible, authentic, and ethical. We need to appropriately tailor our interventions to our clients and their situation.
• Diversity is often greater within groups than between them. Cookbook approaches about working with people from diverse socio-cultural backgrounds are not useful and instead risk potentially dangerous stereotyping and over generalizations.
• We need to challenge and confront all the “Isms” racism, sexism, classism, and other forms of prejudice and discrimination that occur in encounters as well as society-at-large.

Cultural competency is a journey that has a beginning but no end. It begins with recognizing that it is your process and that you own it.