Excerpt

The development of culturally responsive clinical skills is vital to the effectiveness of behavioral health services. According to the U. S. Department of Health and Human Services (HHS), cultural competence “refers to the ability to honor and respect the beliefs, languages, interpersonal styles, and behaviors of individuals and families receiving services, as well as staff members who are providing such services. Cultural competence is a dynamic, ongoing developmental process that requires a long-term commitment and is achieved over time” (HHS 2003a, p. 12). It has also been called “a set of behaviors, attitudes, and policies that … enable a system, agency, or group of professionals to work effectively in cross-cultural situations” (Cross et al. 1989, p. 13).

This Treatment Improvement Protocol (TIP) uses Sue's (2001) multidimensional model for developing cultural competence. Adapted to address cultural competence across behavioral health settings, this model serves as a framework for targeting three organizational levels of treatment: individual counselor and staff, clinical and programmatic, and organizational and administrative. The chapters target specific racial, ethnic, and cultural considerations along with the core elements of cultural competence highlighted in the model. These core elements include cultural awareness, general cultural knowledge, cultural knowledge of behavioral health, and cultural skill development. The primary objective of this TIP is to assist readers in understanding the role of culture in the delivery of behavioral health services (both generally and with reference to specific cultural groups). This TIP is organized into six chapters and begins with an introduction to cultural competence. The following subheadings provide a summary of each chapter and an overview of this publication.

Contents

• Consensus Panel
• KAP Expert Panel and Federal Government Participants
• What Is a TIP?
• Foreword
• Executive Summary
• 1. Introduction to Cultural Competence
  • Purpose and Objectives of the TIP
  • Core Assumptions
  • What Is Cultural Competence?
  • Why Is Cultural Competence Important?
  • How Is Cultural Competence Achieved?
  • What Is Culture?
  • What Is Race?
  • What Is Ethnicity?
  • What Is Cultural Identity?
  • What Are the Cross-Cutting Factors in Race, Ethnicity, and Culture?
  • As You Proceed
• 2. Core Competencies for Counselors and Other Clinical Staff
  • Core Counselor Competencies
  • Self-Assessment for Individual Cultural Competence
• 3. Culturally Responsive Evaluation and Treatment Planning
  • Step 1 Engage Clients
  • Step 2 Familiarize Clients and Their Families With Treatment and Evaluation Processes
  • Step 3 Endorse Collaboration in Interviews, Assessments, and Treatment Planning
  • Step 4 Integrate Culturally Relevant Information and Themes
  • Step 5 Gather Culturally Relevant Collateral Information
  • Step 6 Select Culturally Appropriate Screening and Assessment Tools
  • Step 7 Determine Readiness and Motivation for Change
  • Step 8 Provide Culturally Responsive Case Management
  • Step 9 Incorporate Cultural Factors Into Treatment Planning
• 4. Pursuing Organizational Cultural Competence
  • Cultural Competence at the Organizational Level
  • Organizational Values
  • Governance
  • Planning
  • Evaluation and Monitoring
  • Language Services
  • Workforce and Staff Development
  • Organizational Infrastructure
• 5. Behavioral Health Treatment for Major Racial and Ethnic Groups
  • Introduction
  • Counseling for African and Black Americans
  • Counseling for Asian Americans, Native Hawaiians, and Other Pacific Islanders
  • Counseling for Hispanics and Latinos
  • Counseling for Native Americans
  • Counseling for White Americans
• 6. Drug Cultures and the Culture of Recovery
  • What Are Drug Cultures?
  • The Role of Drug Cultures in Substance Abuse Treatment
• Appendix A Bibliography
• Appendix B Instruments To Measure Identity and Acculturation
• Appendix C Tools for Assessing Cultural Competence
• Appendix D Screening and Assessment Instruments
• Appendix E Cultural Formulation in Diagnosis and Cultural Concepts of Distress
• Appendix F Cultural Resources
• Appendix G Glossary
• Appendix H Resource Panel
• Appendix I Cultural Competence and Diversity Network Participants
• Appendix J Field Reviewers
• Appendix K Acknowledgments

This publication was produced by The CDM Group, Inc., under the Knowledge Application Program (KAP) contract numbers 270-99-7072, 270-04-7049, and 270-09-0307 with the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). Andrea Kopstein, Ph.D., M.P.H., Karl D. White, Ed.D., and Christina Currier served as the Contracting Officer's Representatives.

Suggested citation:

Substance Abuse and Mental Health Services Administration. Improving Cultural Competence. Treatment Improvement Protocol (TIP) Series No. 59. HHS Publication No. (SMA) 14-4849. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

The views, opinions, and content expressed herein are those of the consensus panel and do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. No official support of or endorsement by SAMHSA or HHS for these opinions or for particular instruments, software, or resources is intended or should be inferred.