Читать книгу The Handbook of Language and Speech Disorders - Группа авторов - Страница 36

Cultural (or intercultural) competence (CQ) is a term used to denote behavioral patterns, attitudes, and policies that encourage effective interaction in cross‐cultural contexts (e.g., Cross, Bazron, Dennis, & Isaacs, 1989). Cultural competence is yet another requisite aptitude for clinical service providers, when collaborative and culturally competent practices are aimed for (e.g., Verdon, Wong, & McLeod, 2016; Westby, 2007). Because a person’s cultural experiences change over time, the ability to be effective in cross‐ or multicultural interactions depends upon those life experiences, which themselves ultimately guide one’s conscious and unconscious deeds. The first step is awareness. According to Cross et al. (1989), there are six gradually overlapping stages in acquiring cultural competence, starting with complete lack of it and hostility: destructiveness → incapacity → blindness → pre‐competence → proficiency → cultural responsiveness, and → competence. The term responsiveness (e.g., Hyter & Salas‐Provance, 2019) is preferred over competence (a higher endpoint) to denote a more realistically attainable level of ability, since one’s cultural learning experience has the potential to keep developing throughout one’s lifetime.

To be culturally responsive/competent, a service provider needs to have a degree of acculturation/assimilation of one’s own self (“identity”; Sarbin, 1997) to that of the client and the client’s supporting party (family/peers), that is, to exhibit a combination of knowledge of facts, an ability to empathize (emotional quotient, EQ), as well as, a capacity to fine‐tune one’s behavior with respect to that of others. In other words, cultural competence involves combining a “mindset”, a “heartset” and a “skillset” (e.g., Kim, 2019)—aptitudes that are built on knowledge, awareness, humility, sensitivity, reciprocity, critical and dialectical thinking, linguistic responsiveness, metacognitive skills, and so forth. Beginning with self‐reflection, an actual process of evolution needs to be initiated, often depicted by a spiral: the inner part of the spiral starts with the self (one’s own undercurrent cultural beliefs/values/perspectives that affect one’s resulting behaviors) that expands upwards and outwards, gradually diverging toward an understanding of the self of others, either of one’s own or of different culture(s). Such spiral‐like progression also involves substages in the development of intercultural sensitivity, what Bennett (2004) has identified to be as follows: denial → defense → minimization → acceptance → adaptation → integration; personal attributes affecting this process also include “open‐mindedness,” “self‐concept” (Shavelson & Bolus, 1982), a lack of prejudice, and the capacity to control one’s emotions in social interaction.

Metacognitive skills that positively contribute in enhancing cultural competence involve cognitive flexibility, comparative thinking, and a realization that biases (conscious or unconscious) are acquired, and that, as such, they can also be identified, suppressed, and overcome (e.g., Cheng, 2007). The quest for intercultural competence is open‐ended and varies from individual to individual; it may come as a revelation that so much relevant information goes unnoticed during a therapist’s clinical practicum, due to lack of awareness, or when one does not intentionally scrutinize personal, social, or domestic factors that may affect one’s viewpoint and stances in the interaction with the client, starting at the stage of interviewing to discharge. The ultimate aim of this quest is to primarily maximize communication by first focusing on differences, making sense of them, and then utilizing these differences to the best of one’s ability to address clinical conditions, where such differences may or may not influence the manifestation and/or nature of disorder.

Lastly, cultural competence is vital in gaining control of the ability to treat a client equitably, that is, in a way that best promotes the client’s interests, taking into consideration her/his particular circumstances, which may be different from those of another with a similar diagnosis. Equitable treatment leads to true equality and curtails disparities in clinical service provision, meeting people where they are, not where one thinks they are or should be.