The "Problem" of Cultural Diversity

Child and Adolescent Psychiatric Clinics of North America, 2010

At the time of this writing, the United States is undergoing unprecedented growth in its racial, ethnic, and cultural diversity. 1 And over the past 10 years, it has become a reality that most parents in the United States are living in cultural milieus other than those in which they were raised. 2,3 Thus, child and adolescent psychiatrists must approach all of their work under the presumption of multiculturalism, particularly if a broad definition of culture is chosen that is not limited to ethnic or racial makeup, but rather (as McDermott wrote in 1996) one that embraces the variable values, attitudes, beliefs, and behaviors shared by a people, and that is transmitted between generations. Multiculturalism is based on the assumption that no single "best" way exists to conceptualize human behavior or explain the realities and experiences of diverse cultural groups. 2 Rather, it is more useful, particularly for clinicians, to assume that everyone has a unique culture, and that cultural influences are woven into personality like a tapestry. 4 From this perspective, three of the major tasks for clinicians include (1) developing a broad knowledge base about cross-cultural variations in child development and childrearing; (2) integrating this knowledge in a developmentally relevant way to make more informed clinical assessments and case formulations; and (3) developing a culturally sensitive attitude and therapeutic stance in all interactions with patients and families, including those of the same background as the clinician. 5 Thus, standard assumptions about developmental trajectories may need to be reexamined when considering culture-both across and within cultures. Many contextual factors (including socioeconomic milieu, unique family history and narrative, whether from a rural or urban setting, or temperamental variations) may contribute to the expression

The increasing cultural diversity of child clients has produced a cascade of new issues and concerns for psychological practice, theory, and research. Available evidence and pertinent theory are re- viewed on such topics as the predictive utility and treatment consequences of ethnic membership, whether treatments should be generic or specific to cultural groups, the degree of privilege that should be accorded to same-culture therapists, and the relative desirability of different modalities of treatment for children of different cultural groups. The concept of cultural compatibility of treatment is explored and evaluated. A broad agenda of hypotheses for research and development is suggested, and some guidelines for clinical practice and policy are proposed. It is concluded that insofar as possible, treatment for all children should be contextualized in their family's and community's structure of meanings, relationships, and language.

2009

Cultural diversity is not simply about diversity within recipients of care but also concerns the diversity of care givers* La diversidad cultural no alude sólo a los destinatarios del cuidado, sino también a la diversidad de los cuidadores

Nursing Outlook, 2002

Propelled by a national concern with social justice and health disparities, the notion of cultural competency is being incorporated into both government regulation and professional standards. Although most of the standards that are being developed nationally apply at the institutional level, it is in the clinical setting where the expectation of cultural competency is the most demanding. The recommendations for clinicians to become culturally competent generally fall into 2 major categories. The first focuses on the content and structure of the clinical encounter between provider and patient. The second category charges providers with becoming knowledgeable about the cultures of their constituent patients and learning their lifestyles, health beliefs, and behaviors. Although individuals may belong to the same cultural group, the assumption that they are, in fact, the same, is an ecological fallacy. The health care system has nested the accountability for cultural competence with the clinician who provides direct services to individuals, where the application of cultural information is likely to be least useful. We contend that cultural competence is really nursing competence. "If ever you hear anyone. .. speak of the East,. .. hold your judgment. If you are told 'they are all this' or 'they do this' or 'their opinions are these,' withhold your judgment until all the facts are upon you. Because that land they call 'India' goes by a thousand names and is populated by millions, and if you think you have found 2 men the same among that multitude, then you are mistaken. It is merely a trick of the moonlight." Zadie Smith, from White Teeth 1 We contend that cultural competence is really nursing competence. One would be hard pressed to deny that the flurry of activity around cultural competency is a very good thing. Recognition that the ethnic composition of the population of the United States is changing dramatically and challenging a health care system that is narrowly based in a white, male, middle-class, biomedical model is long overdue. As the United States continues to evolve as a multi-ethnic, culturally diverse society, a standard of cultural competency in all human services is wholesome, desirable, and consistent with the democratic principles on which this nation was founded. It may be time, however, to

Child Refugee and Migrant Health, 2021

Our community in Australia is diverse. Census figures now show that 27% of the resident Australian population were born overseas (ABS, 2011). In addition, 20% of Australians have at least one parent who was born overseas (ABS, 2011), and the number of languages spoken at home by Australians is more than 400 (ABS, 2009). Early childhood education and care (ECEC) services in Australia therefore have contact with families from many different cultural backgrounds.

The term ‘culture’ is considered notoriously ambiguous, complex whole, encompassing almost everything (Sardar & Van Loon, 2004), of which has no operational definition, however most common meaning is the pattern of beliefs, values, habits, ideals, and preferences shared by both small and large groups of people. These cultural characteristics learned in early childhood are mostly unconscious and vital as they have more effect than later influences (Jones, 2006). Despite the challenge in defining the word, Sardar & Van Loon (2004) note cultural studies use a variety of disciplines such as Anthropology, Psychology, Linguistics, and Literary criticism, Art Theory, Musicology, Philosophy and Political Science.

Administration and Policy in Mental Health and Mental Health Services Research, 2010

Evidence suggests that the current mental health system is failing in the provision of quality mental health care for diverse children and families. This paper discusses one critical domain missing to improve care: serious attention given to diversity, culture, and context. It discusses what we mean by understanding culture and context at the individual, family, organizational, and societal level. Focusing on key predictors of children's adjustment in natural contexts would increase attention to building community and family capacities that strengthen children's mental health. To conclude, we suggest changes in organizational culture to build natural supports to enhance children's mental health.

Art Therapy, 2015

Mind, Culture, and Activity, 1998