Standards and Indicators for Cultural Competence in Social Work Practice

Contents

Standards
Introduction
Definitions
Goals and Objectives
Standards and Indicators for Cultural Competence in Social Work Practice
Standard 1. Ethics and Values
Standard 2. Self-Awareness
Standard 3. Cross-Cultural Knowledge
Standard 4. Cross-Cultural Skills
Standard 5. Service Delivery
Standard 6. Empowerment and Advocacy
Standard 7. Diverse Workforce
Standard 8. Professional Education
Standard 9. Language and Communication
Standard 10. Leadership to Advance Cultural Competence
References
Acknowledgments


Standards

Standard 1. Ethics and Values

Social workers shall function in accordance with the values, ethics, and standards of the NASW (2008) Code of Ethics. Cultural competence requires self-awareness, cultural humility, and the commitment to understanding and embracing culture as central to effective practice.

Standard 2. Self-Awareness

Social workers shall demonstrate an appreciation of their own cultural identities and those of others. Social workers must also be aware of their own privilege and power and must acknowledge the impact of this privilege and power in their work with and on behalf of clients. Social workers will also demonstrate cultural humility and sensitivity to the dynamics of power and privilege in all areas of social work.

Standard 3. Cross-Cultural Knowledge

Social workers shall possess and continue to develop specialized knowledge and understanding that is inclusive of, but not limited to, the history, traditions, values, family systems, and artistic expressions such as race and ethnicity; immigration and refugee status; tribal groups; religion and spirituality; sexual orientation; gender  identity or expression; social class; and mental or physical abilities of various cultural groups.

Standard 4. Cross-Cultural Skills

Social workers will use a broad range of skills (micro, mezzo, and macro) and techniques that demonstrate an understanding of and respect for the importance of culture in practice, policy, and research.

Standard 5. Service Delivery

Social workers shall be knowledgeable about and skillful in the use of services, resources, and institutions and be available to serve multicultural communities. They shall be able to make culturally appropriate referrals within both formal and informal networks and shall be cognizant of, and work to address, service gaps affecting specific cultural groups.

Standard 6. Empowerment and Advocacy

Social workers shall be aware of the impact of social systems, policies, practices, and programs on multicultural client populations, advocating for, with, and on behalf of multicultural clients and client populations whenever appropriate. Social workers should also participate in the development and implementation of policies and practices that empower and advocate for marginalized and oppressed populations.

Standard 7. Diverse Workforce

Social workers shall support and advocate for recruitment, admissions and hiring, and retention efforts in social work programs and organizations to ensure diversity within the profession.

Standard 8. Professional Education

Social workers shall advocate for, develop, and participate in professional education and training programs that advance cultural competence within the profession. Social workers should embrace cultural competence as a focus of lifelong learning.

Standard 9. Language and Communication

Social workers shall provide and advocate for effective communication with clients of all cultural groups, including people of limited English proficiency or low literacy skills, people who are blind or have low vision, people who are deaf or hard of hearing, and people with disabilities (Goode & Jones, 2009).

Standard 10. Leadership to Advance Cultural Competence

Social workers shall be change agents who demonstrate the leadership skills to work effectively with multicultural groups in agencies, organizational settings, and communities. Social workers should also demonstrate responsibility for advancing cultural competence within and beyond their organizations, helping to challenge structural and institutional oppression and build and sustain diverse and inclusive institutions and communities.

Introduction                                                             

This revision of the "Standards and Indicators for Cultural Competence in the Social Work Practice" (the Standards) reflects the growth in the understanding of cultural competence since the development of both the NASW "Standards for Cultural Competence in Social Work Practice" published in 2001 and the "Indicators for the Achievement of the NASW Standards for Cultural Competence in Social Work  Practice" (NASW, 2007). These revised standards are anchored in the policy statement “Cultural and Linguistic Competence in the Social Work Profession” published in "Social Work Speaks: National Association of Social Workers Policy Statements" (NASW, 2015) and the NASW (2008) Code of Ethics, which charges social workers with the ethical responsibility to be culturally competent. The "Indicators for the Achievement of the NASW Standards for Cultural Competence in Social Work Practice" was developed in 2007 as an extension of the standards to provide additional guidance on the implementation and realization of culturally competent practice.

This revision, developed by the 2015 NASW National Committee on Racial and Ethnic Diversity, builds on the previous work to introduce new concepts and expand on others. These standards reinforce the concept of “culture” as being inclusive beyond race and ethnicity; inclusive of, but not limited to, sexual orientation, gender identity or expression, and religious identity or spirituality. Similarly, they reinforce the intended audience for these standards to be the broad spectrum of social work practice at the micro, mezzo, and macro levels. The revised standards retain the concept of “competence” as an indicator of attitudes, knowledge, and skills that enable effective cross-cultural practice. As with any competency, there is the expectation of continual growth and learning. The revised standards introduce concepts of “cultural humility,” as a guiding stance vis-à-vis cultural differences, and “intersectionality,” as a way of understanding the complexity of the experiences of those at the margins of our society. In addition, the revision introduces “language and communication” to address a range of communication issues including limited English proficiency, low literacy, and disabilities. Finally, the revisions revisit the way the social work profession engages in leadership to advance cultural competence within the profession, human services, and society at large and to challenge structural and institutional oppression.

NASW “promotes and supports the implementation of cultural and linguistic competence at three intersecting levels: the individual, institutional, and societal. Cultural competence requires social workers to examine their own cultural backgrounds and identities while seeking out the necessary knowledge, skills, and values that can enhance the delivery of services to people with varying cultural experiences associated with their race, ethnicity, gender, class, sexual orientation, religion, age, or disability [or other cultural factors]” (NASW, 2015, p. 65).

The United States is constantly undergoing major demographic changes. The demographic shift is projected to continue with increased diversity in our population — American born and immigrants and refugees. In 1980, 80 percent of the population was white; in 2014, the proportion had decreased to 63 percent and is projected through 2050 to continue this decline to 44 percent (Ortman & Guarneri, n.d.). Shifts in the growth of black, Hispanic, Asian and Pacific Islander, and American Indian/Alaskan Native populations are projected to continue to increase, with more than 50 percent of Americans expected to belong to one of these groups by 2044 (Colby & Ortman, 2015). These demographic changes increase the diversity that social work practitioners, administrators, and executives encounter daily in their settings. These changes affect the social work policy agenda at organizational, community, county, state, and national levels. They challenge social work educators to effectively recruit, retain, and graduate a diverse student body, and to deliver a robust curriculum that embeds the implications of cultural diversity in all aspects of social work practice. Finally, these demographic changes challenge social work researchers to examine questions of relevance to culturally diverse populations and engage in culturally competent research practices. The social work profession, with contributions of pioneers such as Richmond (1922), Reynolds (1935), and Bartlett (1970), traditionally has emphasized the importance of the person-in-environment (PIE) model to address social functioning, in which individuals experience relationships influenced by interrelated factors of environmental, physical, and emotional challenges; Karls and O’Keefe (2008) have advanced the PIE concept to address functionality. Social workers using this ecological perspective for assessment recognize the need to attend to important cultural factors that have meaning for clients.

Diversity, more than race and ethnicity, includes the sociocultural experiences of people inclusive of, but not limited to, national origin, color, social class, religious and spiritual beliefs, immigration status, sexual orientation, gender identity or expression, age, marital status, and physical or mental disabilities. The social work and human services literature include content areas that address culturally appropriate and culturally competent interventions. These include addressing racial identity formation for people of color as well as for white people; the interrelationship among class, race, ethnicity, and gender; working with low-income families; working with older adults; the importance of religion and spirituality in the lives of clients; the development of gender identity and sexual orientation; immigration, acculturation, and assimilation stressors; biculturalism; working with people with disabilities; empowerment skills; community building; reaching out to new populations of color; conscious and unconscious bias; cultural humility, culture-specific and culturally adapted interventions; and training in culturally competent models of practice.

Cultural competence in social work practice implies a heightened consciousness of how culturally diverse populations experience their uniqueness and deal with their differences and similarities within a larger social context.

Concurrently, cultural competence requires social workers to use an intersectionality approach to practice, examining forms of oppression, discrimination, and domination through diversity components of race and ethnicity, immigration and refugee status, religion and spirituality, sexual orientation and gender identity and expression, social class, and abilities. Furthermore, it requires social workers to acknowledge their own position of power vis-à-vis the populations they serve and to practice cultural humility (Tervalon & Murray-Garcia, 1998). The achievement of cultural competence is an ongoing process.

Cultural competence is not just a statement of quality practice. Cultural competence also requires advocacy and activism. It is critically important to provide quality services to those who find themselves marginalized; and it is also essential to disrupt the societal processes that marginalize populations. Cultural competence includes action to challenge institutional and structural oppression and the accompanying feelings of privilege and internalized oppression. Although these standards and their accompanying indicators describe an ideal state, the National Committee on Racial and Ethnic Diversity (NCORED) encourages social work practitioners and agency leaders to put forth good faith efforts to use them.

Definitions                                                                

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.

Macro Practice
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).

Mezzo Practice
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).

Micro Practice
“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
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
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
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.

Cultural Humility
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
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.

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National Association of Social Workers

Darrell P. Wheeler, PhD, ACSW, MPH NASW
President

Angelo McClain, PhD, LICSW NASW
Chief Executive Officer

National Committee on Racial and Ethnic Diversity (NCORED) 2014–2016

Carol E. Bonner, EdD, MSW, MBA (Chair)
Karen Bullock, PhD, LCSW
Yvette Colón, PhD, ACSW, LMSW
Rowena Fong, EdD
Vivian Jackson, PhD, LICSW
Adelaida Montemayor, LCSW, CSSWS
Chathapuram S. Ramanthan, PhD
Nelrene Yellow Bird, LCSW, LAC

National Committee on Racial and Ethnic Diversity 2002–2006 (Indicators)

Sally Alonozo Bell, PhD,  LCSW
Barbara A. Candales, PhD, LCSW, MPH
Iraida V. Carrion, MSW
Betty Garcia, PhD, MSW, LCSW
Mary Hall, PhD, ACSW, LICSW
Vivian H. Jackson, ACSW, LICSW
Claudia Long, PhD, MSW
Adelaida Montemayor, LMSW-ACP
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Clara Simmons, ACSW, DCSW
Saundra H. Starks, EdD, ACSW, LCSW
Rita Takahashi, PhD, MSW
Lann Thompson, MA, MSSW, EdD
Halaevalu F. Vakalahi, PhD
Susan Yi-Millette, ABD, MSW, EdD, ACSW, LCSW

National Committee on Racial and Ethnic Diversity 1999–2001 (Standards)

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Lina Fong, PhD, ACSW, LCSW
Inderjit K. Jaipaul, DSW, ACSW
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Irene Moreda, DSW
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Saundra H. Starks, EdD, ACSW, LCSW
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