Achieving Cultural Competence: Suggestions for Long-Term Change

David Hanna
University of Albany

Race, the most controversial topic of the twentieth century, will realize a new face in the next millennium. We no longer will be able to discuss race and culture as a simple dichotomy, merely white versus black. In the fall APAGS newsletter, Patterson (1999) rightly contends that due to the ever-increasing proportion of minorities in the United States, Western psychology runs the risk of becoming irrelevant to the unique social situations of minority populations. This is due in large part to an educational system that does not explicitly encourage practicum experiences, nor research programs, that address the needs of minority populations. This is unfortunate, because it is the skills gained during graduate course work, internship and postdoctoral training that will allow us to adequately address the unique presenting problems of minority clients. This problem stems, in part, from the often-biased way in which we conduct research.

Historically, theories have been either refuted or confirmed through the use of randomized clinical trials. In terms of research examining psychotherapy efficacy, many treatment modalities have not been tested within minority populations. Research findings, however finite, have been blindly generalized to minority populations. This error has profound effects on the way practitioners are trained because it provides justification for the maintenance of the status quo. That is, it decreases the perceived relevance of cultural competence in research and practice.

So how might future practitioners and practice-oriented researchers increase their cultural competence? Patterson (1999) suggests students seek: 1) diverse personal experiences, 2) diverse training opportunities, 3) supervision with clinicians who have diverse cultural experiences and 4) ask difficult questions of themselves as well as their clients. These are viable starting points for those concerned with the role cultural variables may play in treatment outcome; however, long term change will be achieved through institutional change. While encouragement stems from the grass roots level (i.e. students), change implemented at the institutional level is more likely to affect the greatest number of individuals. We as students must come to the forefront, as cultural competence will prove a more salient issue during the course of our careers. The following are some suggestions to students:

1. Raise a skeptical eye at literature that assumes the definitions of overall psychological well-being and the adaptive coping strategies of different groups are equivalent. This is a fundamental error that must be addressed through careful study of individual minority groups.
2. Consume research reported in all bodies of literature concerning minority populations.
3. Seek collaborations with ethnic specific organizations such as the Association of Black Psychologists, and the Asian American Psychological Association.
4. Encourage program directors to hire minority faculty members and increase the diversity of curriculum offerings.
5. Most importantly, for students to become more aware of issues relevant to culture, you must come out of your comfort zone. You must be willing to tread in areas where you have a limited amount of knowledge while remaining cognizant of the biases you inherently bring to the therapeutic process. This I believe will signify a great step in the direction of gaining cultural competence.

This article first appeared in the Winter 2000 Edition of the APAGS Newsletter, Vol. 12(1)