Cultural Competence: The Nuts & Bolts of Diversity & Inclusion

MERCEDES MARTIN & BILLY VAUGHN

Cultural competence is at the heart of managing diversity. While a few people seem to be born with cultural competence, the rest of us have had to put considerable effort into developing it. This means, in part, doing a lot of personal work on our biases and prejudices, searching for role models, and taking advantage of opportunities to share our passion for cultural competence with colleagues. Mostly, it means a commitment to learning about cultural differences, developing cross-cultural skills, and learning from our mistakes along the way.

Few diversity professionals will likely disagree with the above characterization of becoming culturally competent, but each will likely have a different definition for the term.

The term multicultural competence surfaced with a mental health publication by psychologist Paul Pedersen (1988) at least a decade before the expression cultural competence became popular.((P. B. Pedersen (1988). A handbook of developing multicultural awareness. Alexandria, Va: American Association for Counseling and Development.)) Most of the definitions of cultural competence shared among diversity professionals come from healthcare.

Consider the following definitions:

• A set of congruent behaviors, attitudes and policies that come together as a system, agency or among professionals and enable that system, agency or those professionals to work effectively in cross-cultural situations. (T. L. Cross, et al., 1989)((T., Bazron, B., Dennis, K., & Isaacs, M., (1989). Towards A Culturally Competent System of Care, Volume I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.))
• Cultural competence requires that organizations have a defined set of values and principles, and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally. (T. Taylor, et al., 1998)((Taylor, T., et al. (1998). Training and Technical Assistance Manual for Culturally Competent Services and Systems: Implications for Children with Special Health Care Needs. National Center for Cultural Competence, Georgetown University Child Development Center.))
• Cultural competence is defined simply as the level of knowledge-based skills required to provide effective clinical care to patients from a particular ethnic or racial group. (D. Denboba, 1993)((Denboba, D., (1993). MCHB/DSCSHCN Guidance for Competitive Applications, Maternal and Child Health Improvement Projects for Children with Special Health Care Needs. U.S. Department of Health and Human Services, Health Services and Resources Administration.))
• Cultural competence is a developmental process that evolves over an extended period. Both individuals and organizations are at various levels of awareness, knowledge and skills along the cultural competence continuum (Betancourt et al., 2002; Betancourt, J., Green, A. & Carrillo, E. 2002). Cultural competence in health care: Emerging frameworks and practical approaches. The Commonwealth Fund.)

First of all, it is not surprising that the mental health and medical care professionals were at the forefront of promoting cultural competence. The consequences of a poor diagnosis due to lack of cultural understanding, for example, can be very costly to the patient–especially in medical service delivery. Cultural incompetence in the business community can lead to dire consequences, but the unobservable effects can largely go unnoticed until threat of a class action suit (e.g., stress-related medical problems, absenteeism, employee turnover, etc.). The harm to individuals caused by cultural incompetence appears to be a concern only to the extent that it is referenced in terms of cost to the institution. It is rather obvious why poor judgment can result in lawsuits in the medical and mental health fields. In either case, more data is needed to show the superior performance resulting from cultural competence. This will strengthen diversity education as an important productivity build solution.

Notice that some of the above definitions emphasize the knowledge and skills needed to work with people of different cultures, while others focus on attitudes toward people of different cultures. In fact, even policies and organizations are represented as having more or less cultural competence in a couple of the definitions. Working with terms that vary in definition can be risky.

If members of a diversity committee employ a unique definition of cultural competence in decision-making, they will have a difficult time getting their work done efficiently. At some point the group will have to take precious time away from the task in order to discuss how to resolve the differences in definition. If a diversity steering committee is unable to smoothly resolve differences in terminology, members of the organization who oppose the diversity program can use the lack of harmony to undermine committee’s efforts. Diversity professionals can better serve clients and share knowledge when they use similar terminology. It’s possible, and often beneficial to use different definitions for different purposes, as long as the entire team agrees to the definitions.

Check Out the What is Cultural Competence? by Billy Vaughn, PhD CDP

The point is that building all four cultural competence components must be considered in diversity education. Attitude change alone, for example, does not lead to knowledge about different cultures. Awareness or sensitivity training does not necessarily result in acceptance of cultural differences. Teaching about cultural differences or training cross-cultural skills before understanding the individual’s awareness of differences can be dangerous. There is also the problem of over-generalization. What we learn about Muslim culture, for example, may be very valuable in preparation for an assignment in Saudi Arabia, but less useful for managing a mix of first and second-generation Muslim immigrant employees in a company based in Brussels, Belgium. When we treat people according to social category stereotypes, such their race or religion, we make the classic mistake of failing to take their individual differences and circumstances into consideration. This is the basis of exclusion in everyday encounters between people of different cultures. The remainder of this article proposes a definition of cultural competence to stimulate discussion among diversity professionals. The authors define cultural competence as comprised of the following four components: (a) Awareness, (b) Attitude, (c) Knowledge, and (d) Skills.((Devine, P. G. (1996). Breaking the prejudice habit. Psychological Science Agenda Science Briefs. Washington, D. C.: APA Science Directorate; Devine, P. G., & Monteith, M. J. (1993). The role of discrepancy-associated affect in prejudice reduction. In D. Mackie & D. Hamilton (Eds.), Affect, cognition, and stereotyping: Interactive processes in group perception (pp. 137-166). San Diego: Harcourt, Brace, & Jonanovich.; Devine, P. G., Monteith, M. J., Zuwerink, J. R., & Elliot, A. J. (1991), Prejudice with and without compunction. Journal of Personality and Social Psychology, 60, 817-830.))

Our definition is based on Pedersen’s multicultural competence model, which emphasizes awareness, knowledge and skills. We separate the attitude component apart from awareness in our work to emphasize the difference between training that focuses on bringing our cultural bias and beliefs into consciousness and that which assists us in carefully examining beliefs and values about cultural differences.

Awareness, for example, occurs when we are conscious of our personal reactions to people who are different. A police officer is culturally aware when she recognizes that she profiles young men as gangsters when they look Mexican, wear a bandana, drive low-rider cars, and play loud Mexican music.

Social science research indicates that our values and beliefs (i.e., our attitudes) about equality may be inconsistent with our behaviors, and ironically we may be unaware of it. Social psychologist Patricia Devine and her colleagues showed in their research that many people who are low in prejudice tend to do things in cross cultural encounters that exemplify prejudice (e.g., using out-dated labels such as ‘illegal aliens”, ‘colored”, and ‘homosexual”.).((Kegan, R., & Lahey, L. (2001). How the way we talk can change the way we work. Jossey-Bass: San Francisco, CA.)) This is where the Knowledge component diversity education becomes important.

Regardless of whether our attitude towards cultural differences matches our behaviors, we can all benefit from improving our cross-cultural effectiveness. Diversity professionals attempt to create inclusive systems within organizations so that members can be the most productive.

The Skills component goes beyond learning techniques to proficiently using them. Talk is the fundamental tool with which people interact in organizations. Robert Kegan and Lisa Lahey have developed seven styles of communication to transform how people work together.9 We add compassionate communication to their list, which we feel goes beyond the sensitivity and awareness training that diversity education appears to be locked into today for the most part.

The set of four components of our cultural competence definition represent the key features of each of the popular definitions. Ours go beyond integrating previous definitions however by integrating diagnostic and intervention to strengthen its practical application.

To appreciate the utility of our cultural competence definition, we will now describe how it can be incorporated into a developmental stage model of inclusion.

Cultural Competence Development Stage Model: from Exclusion to Inclusion ((Vaughn, Billy E. and Mlekov, Katarina, ‘A Stage Model of Developing an Inclusive Community” (January 2003). FEEM Working Paper No. 17. 2003. Available at SSRN: http://ssrn.com/abstract=389283 or DOI: 10.2139/ssrn.389283))

A culturally competent organization is assumed to be an inclusive one. The model in this section describes the stages through which an organization becomes inclusive as its cultural competence increases.

The model is based on the assumption that organizations go through a set of developmental stages in achieving an inclusive culture.11 Assessment determines the current developmental stage and the corresponding intervention needed to reach higher stages.

Other assumptions are that:

• Change is a process
• Change occurs in stages
• Change is more spiral than linear, (i.e., the organization goes through valleys and mountains in reaching higher stages of inclusion due to backlash, economic changes, business unit capacity differences, and other factors).
• Organizations must be prepared to fully realize inclusion
• Organizations and individuals go through a similar set of developmental stages

Stages of Cultural Competence Development ((We give credit to Judith Katz and Fred Miller for their organizational inclusion model published in the 1990s. Our cultural competence description is influenced, in part, by this earlier work.))

The five stages of cultural competence development from the lowest to the highest are:

• Conventional (Lowest cultural competence stage)
• Defensive
• Ambivalent
• Integrative
• *Inclusive (Highest cultural competence stage)

Cultural competence increases as an organization or individual reaches the higher stages of inclusion. Movement towards higher stages requires commitment, education, training, and considerable practice.

The following is a characterization of each stage.

Conventional Stage

• Lacks awareness of bias towards people of other cultures. Perceives own language and culture as superior to others.
• Aversion towards cultural differences. Discomfort in interactions with people who are different in race, language, sexual orientation, etc. due to prejudice.
• Cultural stereotypes and ethnocentric knowledge about cultural differences.
• Lacks intercultural skills. Avoids learning about other cultures.

Defensive Stage

• Inequality is considered a natural result of differences in group abilities. At the same time, awareness of societal pressure to accept equality results in guarding against stereotypes in public.
• Discomfort with diversity leads to avoiding contact whenever possible in order to protect against being labeled as prejudiced.
• Knowledge about cultural differences is based on cultural stereotypes and ethnocentrism.
• Low in cross-cultural skills, but willing to learn about other cultures in order to avoid being perceived as prejudiced. Lacks the skills needed to competently work with members of other groups, which results in feeling angry and resentful in cross-cultural interactions in which the individual may feel obliged to show tolerance and competence. Manages social pressure by pretending to be less prejudiced than personal beliefs actually support.

Ambivalent Stage

• Awareness that bias causes inequality, but does not view herself, himself, or the organization as biased.
• A belief in equality, but suffers from a disconnection between egalitarian perceptions of individual diversity attitudes and a sense of inadequacy in managing encounters with people who are different. Prefers to focus on institutional barriers to inequality and obvious acts of discrimination while ignoring serious efforts to explore individual and hidden bias.
• Knowledge about cultural differences is based on cultural stereotypes and ethnocentrism apart from a few examples of historically excluded group members who are exceptions (e.g., ‘Most immigrants do not learn Swedish.” ‘If they could only show some respect for our generosity like the one Ethiopian immigrant who speaks our language better than most us”).

Intercultural skills are low. Asks historically excluded group members a lot of questions about their differences in order to learn more about cultural differences and to show sincerity in valuing equality. Feels uncomfortable about discussing own racial or cultural group (e.g., does not want to appear supportive of ‘white supremacy” or lacking in knowledge and awareness).

*Integrative Stage

• Awareness of both personal and organizational biases that create inequality among cultural groups.
• Integration of cultural awareness, attitude, and behaviors. Disdain for people with prejudice and bias towards cultural differences. Continues to struggle with a sense of valuing his or her cultural group.
• Positive cultural stereotypes. Considerable knowledge about various cultural differences and how culture influences behavior. Difficulty accepting people who are not as far along in becoming inclusive as themselves.

• Treats people as both individuals and members of a cultural group. Very comfortable with cultural differences. Feels increasingly comfortable when she or he is a ‘minority” in a group or organization. Actively points out the lack of cultural competence among members of the majority group, and has taken on the responsibility for changing them.

*Inclusive Stage

• Awareness of any remaining cultural and personal biases.
• Consistency between intercultural beliefs/values and behavior.
• Positive cultural stereotypes. Considerable multicultural knowledge and constantly seeking more knowledge.
• Prefers multicultural experiences and feels uncomfortable in monocultural settings. Feels very comfortable in cultural immersion. Often seeks to learn at least one other language and spend considerable time in another culture. Knows how to work with members of other groups in the organization, and enjoys it. Not afraid to make mistakes in learning about new cultures.

Assessment determines the present stage of development.

A set of recommended interventions that can be implemented in order to reach higher stages is associated with the stage identified by the assessment results. A Defensive stage organization, for example, can benefit from developing and communicating a strong business case for promoting diversity. The Ambivalent stage organization, on the other hand, needs stronger diversity leadership and managing diversity practices.

This overview of the cultural competence stage model emphasizes how the four-component definition enables us to strategically define the inclusion gaps within organizations and reference them to a body of knowledge about how to intervene. Other cultural competence definitions fall short of including the full range of components needed to assess inclusion gaps.

Our goal has been to offer diversity professionals terminology and models that will enable them to collaborate more efficiently, as well as to more effectively deliver services. Getting on the same page about terminology can be very unproductive, and is more properly saved for seminars, conferences, and in knowledge sharing articles.

As stated at the beginning of this article, we are not claiming to have developed the ultimate definition of cultural competence. Our aim is only to invite and inspire others to contribute to working towards a definition that we can reasonably agree on. If others have ideas for making it better, then we have met our goal.

* The updated version of the cultural competence stages are as follows: conventional, defensive, ambivalent, egalitarian, and integrative. The changes in wording does not impact the definitions stated above.

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