In 2015 NCORED revised the definitions of culture and cultural competence and added definitions of cultural humility and intersectionality that are important to social work practice at the micro, mezzo, and macro levels. Definitions are drawn from the NASW (2008) Code of Ethics, the 10th edition of Social Work Speaks (2015), the 6th edition of The Social Work Dictionary (Barker, 2013), and other academic sources.
Areas of Practice
In these standards, “practice” refers to at all levels of practice—micro, mezzo, and macro.
Social work practice “aimed at bringing about improvement and changes in the general society. Such activities include some types of political action, community organization, public education campaigning, and the administration of broad-based social services agencies or public welfare departments” (Barker, 2013, p. 253).
Refers to “social work practice primarily with families and small groups. Important activities at this level include facilitating communication, mediation, and negotiation; educating; and bringing people together” (Barker, 2013, p. 269).
“The term used by social workers to identify professional activities that are designed to help solve the problems faced primarily by individuals, families, and small groups. Usually micro practice focuses on direct intervention on a case-by-case basis or in a clinical setting” (Barker, 2013, p. 269).
Cissexism is discrimination against individuals who identify with and/or present as a different sex and gender than assigned at birth and privilege conveyed on individuals who identify with and/or present as the same sex and gender as assigned at birth. It is a form of sexism based on sexual and gender identity and expression (Hibbs, 2014).
Culture is a universal phenomenon reflecting diversity, norms of behavior, and awareness of global interdependence (Link & Ramanathan, 2011).
The word “culture” implies the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group (Gilbert, Goode, & Dunne, 2007). Culture often is referred to as the totality of ways being passed on from generation to generation. The term “culture” includes ways in which people with disabilities or people from various religious backgrounds or people who are gay, lesbian, or transgender experience the world around them. Culture includes, but is not limited to, history, traditions, values, family systems, and artistic expressions of client groups served in the different cultures related to race and ethnicity, immigration and refugee status, tribal status, religion and spirituality, sexual orientation, gender identity and expression, social class, and abilities.
The Preamble to the NASW (2008) Code of Ethics states, “The primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty” (p. 1). And it continues, “Social workers are sensitive to cultural and ethnic diversity and strive to end discrimination, oppression, poverty, and other forms of social injustice” (p. 1).
Cultural and ethnic diversity is mentioned in two ethical standards:
1. Value: Social Justice
Ethical Principle: Social workers challenge social injustice.
Social workers’ social change efforts are focused on issues of social injustice.
These activities seek to promote sensitivity to and knowledge about oppression and cultural and ethnic diversity.
2. Value: Dignity and Worth of the Person
Ethical Principle: Social workers respect the inherent dignity and worth of the person.
This value states that social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity.
Cultural competence refers to the process by which individuals and systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, religions, spiritual traditions, immigration status, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each (Fong, 2004; Fong & Furuto, 2001; Lum, 2011). “Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system or agency or amongst professionals and enable the system, agency, or those professions to work effectively in cross-cultural situations” (National Center for Cultural Competence, n.d., p. 1).
Operationally defined, cultural competence is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services, thereby producing better outcomes (Davis & Donald, 1997). Competence in cross-cultural functioning means learning new patterns of behavior and effectively applying them in appropriate settings. Gallegos (1982) provided one of the first conceptualizations of ethnic competence as “a set of procedures and activities to be used in acquiring culturally relevant insights into the problems of minority clients and the means of applying such insights to the development of intervention strategies that are culturally appropriate for these clients” (p. 4).
This kind of sophisticated cultural competence does not come naturally to any social worker and requires a high level of professionalism and knowledge. Other culturally related terms exist, such as “cultural responsiveness,” “cultural proficiency,” and “cultural sensitivity.” Note that the definitions of some of these terms are similar to the definitions of cultural competence. However, others, such as “cultural sensitivity,” do not incorporate an expectation of skillful or effective action.
On the organizational level, there are five essential elements that contribute to a culturally competent system (Cross, Bazron, Dennis, & Isaacs, 1989). The system should (1) value diversity, (2) have the capacity for cultural self-assessment, (3) be conscious of the dynamics inherent when cultures interact, (4) institutionalize cultural knowledge, and (5) develop programs and services that reflect an understanding of diversity between and within cultures. These five elements must be manifested in every level of the service delivery system. They should be reflected in attitudes, structures, policies, and services. The specific ethical standard for culturally competent social work practice is contained under Section 1 of the NASW (2008) Code of Ethics: Social Workers’ Ethical Responsibilities to Clients.
1.05 Cultural Competence and Social Diversity
- Social workers should understand culture and its functions in human behavior and society, recognizing the strengths that exist in all cultures.
- Social workers should have a knowledge base of their clients’ cultures and be able to demonstrate competence in the provision of services that are sensitive to clients’ cultures and to differences among people and cultural groups.
- Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability.
Finally, the NASW (2008) Code of Ethics reemphasizes the importance of cultural competence in Section 6: Social Workers’ Ethical Responsibilities to the Broader Society.
6.04 Social and Political Action
- Social workers should act to expand choice and opportunity for all people, with special regard for vulnerable, disadvantaged, oppressed, and exploited people and groups.
- Social workers should promote conditions that encourage respect for cultural and social diversity within the United States and globally.
- Social workers should promote policies and practices that demonstrate respect for difference, support the expansion of cultural knowledge and resources, advocate for programs and institutions that demonstrate cultural competence, and promote policies that safeguard the rights of and confirm equity and social justice for all people. Social workers should act to prevent and eliminate domination of, exploitation of, and discrimination against any person, group, or class on the basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical disability.
- Cultural competence is never fully realized, achieved, or completed; it is a lifelong process for social workers who will always encounter diverse clients and new situations in their practice. Supervisors, colleagues, and workers should have the expectation that cultural competence is an ongoing learning process integral and central to daily supervision.
For development of cultural competence knowledge, training, acquiring, and use of skill sets to be effective, we need to be both aware and attentive to the dynamic quality of culture and be committed to the practice of cultural humility. Cultural humility is an important facet of professional identity that encourages self-evolvement and evolvement of self through one’s professional life. It also includes evolvement of the profession’s identity that bridges social distance as well as power differential between the social worker and client systems (Ramanathan, 2014).
Cultural humility refers to the attitude and practice of working with clients at the micro, mezzo, and macro levels with a presence of humility while learning, communicating, offering help, and making decisions in professional practice and settings. According to Tervalon and Murray-Garcia (1998), “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 non-paternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations” (p. 117). As Hook, Davis, Owen, Worthington, and Utsey (2013) suggested, cultural humility is a way of maintaining an interpersonal stance that is other-oriented.
Intersectionality theory (grounded in a feminist perspective) examines forms of oppression, discrimination, and domination as they manifest themselves through diversity components (Crenshaw, 1989; Hancock, 2007; Hunt, Zajicek, Norris, & Hamilton, 2009; Viruell-Fuentes, Miranda, & Abdulrahim, 2012). These diversity
components include such multiple identities as race and ethnicity, immigration, refugee and tribal status, religion and spirituality, sexual orientation, gender identity and expression, social class, and mental or physical disabilities. An intersectionality approach to social work practice at the micro, mezzo, and macro levels includes integrating the various diversity components and identities and approaching practice from a holistic point of view. For example, a social worker would approach a first-generation client in the context of the client’s family and with recognition of the person’s race and ethnicity, religion and spiritual expression, social class, sexual orientation, abilities, and other factors. Intersectionality theory is reinforced by critical race theory and social systems theory, emphasizing human behavior in the social environments. Thus, intersectionality perspective provides a comprehensive approach with a commitment to social justice and captures transactions in the PIE configuration that form the common base for social work knowledge and practice.
Goals and Objectives
These standards provide focus for the development of culturally competent social work practice. These standards provide guidance to social workers in all areas of social work practice in responding effectively to culture and cultural diversity in policy and practice settings.
These standards, revised in 2015, incorporate updated literature in culturally competent practice. These revised standards are intended to be inclusive of all populations served and focused on self-awareness, cultural humility, and the dynamics of power and privilege. Cultural humility, which is integral to culturally competent practice, is described and highlighted in this revision of the standards.
The specific goals of the standards are to:
- enhance knowledge, skills, and values in practice and policy development relative to culturally diverse populations
- articulate specific standards to guide growth, learning, and assessment in the area of cultural competence
- establish indicators so that social workers in all areas of practice can monitor and evaluate culturally competent practice and policies in relationship to these standards
- educate consumers, governmental regulatory bodies, insurance carriers, and others about the profession’s standards for culturally competent practice
- maintain or improve the quality of culturally competent services provided by social workers in agencies, programs, and private practice settings
- inform specific ethical guidelines for culturally competent social work practice in agency and private practice settings
- document standards for agencies, peer review committees, state regulatory bodies, insurance carriers, and others.