Cultural Competence, Awareness and Humility
While nature shapes a part of who we are, nurture has an equally big influence on our identity. Culture can influence our sense of self, decision-making and how we relate with others. Very often, aspects of our culture lay hidden from our awareness until we interact with others from another culture. Here’s a brief introduction to three relevant concepts around cultural sensitivity that can help us navigate cultural differences - cultural competence, cultural awareness and cultural humility.
In an increasingly globalised world, we have more and more opportunities to interact with people from different geographical backgrounds, and with that different cultural histories. The beauty is that we have more opportunities than ever to connect with diverse cultures in our everyday lives. Challenges however come with the possibility for misunderstanding, miscommunication or even judgment and inequality for minority groups.
It might be helpful to look back at the history of paradigms around cultural considerations to contextualise more current ideas around diversity. The early years of colonisation and European settlement came with assimilation being the prominent idea through the 18th, 19th to mid-20th centuries. Assimilation involves the absorption of minority cultures into the dominant culture of a society, from religion, values and language, through to aesthetics.
In the late-20th century, a more pluralistic approach to cultural diversity encouraged greater emphasis on respecting individual differences not only across race and ethnicity, but also age, gender, ability, sexual orientation, religion, and political affiliation. The shift led to the idea of Cultural Competence being first introduced in 1988 by mental health researcher Terry L. Cross. Cultural competence is defined as the ability to understand, communicate and effectively interact across cultures. It is an idea that has seeped into many of today’s cultural trainings, especially in corporate spheres. Cross proposed that there are 6 stages of cultural competence:
Cultural destructiveness - overt discrimination (e.g. assimilation)
Covert discrimination - such as stereotyping and othering
Cultural blindness - asserting the absence of bias, yet assuming dominant ideas as universally applicable
Cultural precompetency - respecting minority groups, but lacking possible adaptations to accommodate for differences
Cultural competence - accepting and respecting minority groups, with the knowledge and skills to adapt to different populations
Cultural proficiency - furthering the knowledge base through research and experimentation, supporting minority groups to help themselves
The idea of “competence” in general implies mastery of the necessary skills and knowledge to respond to any given situation or task. While with its merits, cultural competence however suggests a unidirectional stance, generally around individuals from the dominant group developing the knowledge and skills to work with minority groups. In doing so, the idea of cultural competence runs the risk of reinforcing stereotypes, implicit stigmatising attitudes and behaviours.
Moving away from competency and acquisition of skills and knowledge alone, cultural awareness encourages an attitude of mindfulness and sensitivity to similarities and differences between people of different groups. It involves holding values and attitudes of being respectful and open to different cultures, languages, beliefs, communication, norms and ways of being. Cultural awareness also includes the awareness of dynamics of power, privilege, and oppression between the dominant and minority cultures.
Cultural humility was first proposed by healthcare professionals Tervalon and Murray-Garcia (1998). It involves not only efforts to learn about other cultures, but also efforts towards self-reflection and examination of our own values, biases, assumptions and prejudices. The concept extends on the mere awareness of imbalanced power dynamics by taking away the ‘expert’ stance. It involves the acknowledgement that we don’t know everything and encourages us to hold an openness to learn about others’ experiences, acknowledgement of individual lived experiences, while being aware of our immersion in our own cultural backgrounds. Cultural humility involves an ongoing process of self-reflection with no “end-point” of competence. In the words of Tervalon and Murray-Garcia themselves:
“Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.” (Tervalon & Murray-Garcia, 1998, p. 117)
While originally developed in health settings, these three concepts are helpful for us in our everyday lives. Although with their own nuances, these concepts all generally invite the perspective of respect and openness to differences. Cultural humility adds the extra reminder to stay humble about our limitations, and encourage lifelong commitment to self-reflexivity. Mistaken assumptions of ‘knowing it all’ can present a barrier to the very openness that is needed for fostering a deeper understanding of others. Together, these concepts encourages us to be mindful of the differences in how others may view themselves, others, and the world around them; it also encourages us to be mindful of our own biases and limitations; it also encourages us to suspend our judgment in any given situation. Paradoxically, holding space for differences allows us to foster a deeper appreciation of our shared similarities and common humanity - an understanding that is not only helpful for our work, but also our social and personal lives.
Resources
Barsky, A. (2018, Fall). Ethics Alive! Cultural Competence, Awareness, Sensitivity, Humility, and Responsiveness: What's the Difference?. The New Social Worker. https://www.socialworker.com/feature-articles/ethics-articles/ethics-alive-cultural-competence-awareness-sensitivity-humility-responsiveness/
Cross, T. (1988). Cultural Competence Continuum, Focal Point Bulletin. https://www.pathwaysrtc.pdx.edu/pdf/fpSU88.pdf
Federation of Ethnic Communities’ Councils of Australia (FECCA). 2019. Cultural Competence in Australia - A Guide. Australian Government, Department of Home Affairs. https://fecca.org.au/wp-content/uploads/2019/05/Cultural-Competence-in-Australia-A-Guide.pdf
Foronda C. (2020). A Theory of Cultural Humility. Journal of Transcultural Nursing, 31(1), 7–12. doi: 10.1177/1043659619875184
Kohli, H.K., Huber, R., & Faul, H.C. (2010). Historical and Theoretical Development of Culturally Competent Social Work Practice. Journal of Teaching in Social Work, 30(3), 252–71. doi:10.1080/08841233.2010.499091.
Lekas, H.M., Pahl, K., & Fuller Lewis, C. (2020). Rethinking Cultural Competence: Shifting to Cultural Humility. Health Services Insights,13. doi: 10.1177/1178632920970580
Tervalon M., Murray-García J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9, 117–125.
