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Article Excerpt
What could possibly be amiss with the idea of cultural competence (CC), that is, social workers possession of "a knowledge base of their clients' cultures" and ability to provide "services that are sensitive to clients' cultures" (NASW, 2000a, p. 9)? After all, CC sounds as inviting and benign as an Indian samosa, an Irish scone, or American apple pie.
The social work literature is rich in its discussions of CC, and such discussions are evident in texts that discuss international social work (Healy, 2001), social policy (van Wormer, 1997), human behavior (Robbins, Chatterjee & Canda, 2006), and micro social work practice (Leigh, 1998).The most recent Council on Social Work Education (CSWE) (2008) Educational Policy and Accreditation Standards mandate schools (accredited by CSWE) to educate students at the bachelor's and master's levels on 10 core competencies, two of which emphasize the influence of culture on identity and human development (core competencies 4 and 7, respectively). Although the notion of CC has received some critical commentary (see, for example, de Anda, 1997, for a range of opinions), the place of CC in the U.S. social work curriculum appears relatively uncontested.
In this article, we hope to show that, although the notion of CC has been espoused with the worthiest of intentions for social work practice, education, theory, and research, there are conceptual tensions at its center. Our intention is to not discredit the enormous amount of work on CC that has been developed over the years. We do not recommend ignorance of global history and national and international current conditions that include genocide, slavery, oppression, racism, and gross health disparities; the literature on CC that educates social workers about these issues is to be applauded. Rather, we wish to highlight some aspects of the underlying conceptual framework of CC that run contrary to established social work principles and practice and that we believe have been only modestly addressed previously. More specifically, our concerns lie with the CC literature that recommends practice standards concerning, or purports to educate social workers about, the values, worldviews, personality traits, and norms of racial and ethnic groups. The contradictions we identify extend to the epistemological foundations of CC, the rights and dignity of the individual, and the very question of whether a social worker can ever be culturally competent. Moreover, we are by no means alone in our desire to critically examine the conceptual underpinnings of CC; we encounter voiced reservations about the tenability of CC in the arenas of practice, teaching, and professional meetings (Johnson & Munch, 2006).
CC has become an established feature of social work and is found in formal (for example, NASW, 2007; U.S. CSWE publications [for example, Armour, Bain, & Rubio, 2006]) and informal social work parlance. It could be argued that CC has become entrenched within the very culture of social work and appears to have been embraced by many in the profession. This might lead to reticence in challenging the concept of CC for fear of appearing insensitive to cultural issues or even being anti--social work values. However, the established status of CC should not imply immunity from critical analysis. Indeed, there is all the more reason for this investigation; if what the social work profession takes for granted is on less than coherent and rigorous grounds, then an attempt at reassessment or remedy might be not only beneficial, but also imperative.
First, in this article, the discussion focuses on the historical context within which CC emerged. Second, a conceptual analysis of terminology related to CC is undertaken. Third, contradictions noted in the CC literature are examined through the lens of ethics and current identity politics from the field of philosophy juxtaposed with social work values, practice, education, and research. We wish to enhance and deepen the current discussion of CC by incorporating the work of Kwame Anthony Appiah (1994, 2003,2005) and Charles Taylor (1991, 1994), two of the most prominent philosophers whose works address collective identities and group rights. Although we conducted a literature review on CC using well-regarded databases (for example, Social Service Abstracts and PsychINFO, using key words such as "cultural competence" and "cultural humility"), this article does not constitute an overarching literature review of CC; rather, it is a conceptual presentation of the tensions we have identified in the CC literature.
BACKGROUND
From its very beginnings, social work has, in varying degrees, paid attention to matters related to race and ethnicity (see, for example, National Conference on Social Welfare Proceedings, 1874-1982). Settlement houses--before their decline during World War I--and the New Deal provided increasing evidence of social welfare's concern with the needs of ethnic and racial minorities (Trattner, 1998). Much of the recent discussion on race and ethnicity in the United States arose from the acknowledgment of Eurocentric bias in the teaching of public school students about history, literature, and social science (Gould, 1995). Social work education began to address racial and ethnic disparities and culture during the U.S. civil rights movement of the 1960s (Rothman, 2008). Given the prominence of this movement in the United States in the 1960s and 1970s, discussions of culture tended to be focused on race and ethnicity, and diversity was usually taken to be synonymous with acknowledging differences in skin color. This historical emphasis can still be seen in current literature on CC, although broader definitions, including, for example, sexual orientation and physical differences, exist (NASW, 2007). Efforts to correct pathology-laden, stereotyped characterizations of oppressed racial and ethnic minority groups led to the development of social work textbooks that devoted chapters to African Americans, Asians, and Hispanics, for example, and ultimately promoted strengths-based characterizations.
The interest in CC is not limited to the profession of social work and extends to counseling (American Counseling Association, 2005) and nursing (Denboba, 2005/2006). On a macro level in relation to health, for example, the mission of the U.S. National Center for Cultural Competence (NCCC) is to increase the capacity of health care and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery (Goode, 2001).The creation of the NCCC was prompted by research showing that health disparities are associated with race, wealth, age, and gender (see, for example, Mental Health: A Report of the Surgeon General, 1999; President's New Freedom Commission on Mental Health, 2003). In addition, the promotion of health and mental health programs that implement and evaluate culturally and linguistically competent service delivery systems can be seen on an international basis (for example, Victorian Transcultural Psychiatry Unit [Australia], 2007).
To tease out what is encompassed in the term CC, definitions of culture, competence, and CC are needed. The term "culture" is elusive. Definitions presented in Table 1 show the huge areas of social life to which culture refers (definitions of the terms that are irrelevant for our purposes--for example, refined taste---are excluded). Culture encompasses a group's social history over generations, rituals, beliefs, behaviors, and material artifacts. NASW (2000b, 2007) includes the subjective experiences of people within specific cultures. Competence involves abilities and skills, and the specific ones required of CC are discussed later in this article.
The tenets of CC have been found in the social work literature for nearly 40 years under different, though similar, terminology. Because of space limitations, we cannot list every definition of CC; Boyle and Springer (2001) purported that there are possibly hundreds. However, the definitions of CC in Table 1 are illustrative of the definitions commonly found in the social work literature. Noticeable in the definitions of CC over time is the growing recognition that society might be best understood as an entity comprising many cultures rather than two--that is, minority and majority (Norton, 1978).
CONTRADICTIONS IN THE IDEA OF CC
We identify four major contradictions in formulations of CC. (1)The first is epistemological--that is, related to questions of knowledge and the manner in which the knowledge is obtained. We argue that the emphasis on a priori knowledge of cultural difference not only is limited in terms of its accuracy, but also is contrary to the...
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