Cultural competent services are necessary for a developing a system of effective prevention and treatment and recovery service delivery. Incorporating various beliefs and values should be promoted through agency plans, goals and objectives. Acknowledging a person’s culture is most important to their recovery and the services they receive from agencies. Cultural issues influence recidivism, cost effectiveness, quality of care and retention in programming, Cultural competence should include an understanding of behaviors, valuing diversity, expanding cultural knowledge and an acceptance and respect for differences in values, beliefs, value of diversity and communication.

The NationalCenterfor Cultural Competence (NCCC)

[ http://gucchd.georgetown.edu//nccc/index.html [1] ] embraces a conceptual framework and model for achieving cultural competence based on the work of Cross et al. (1989). The NCCC uses the following definitions and model to underpin all activities.

Definitions & Framework

Cultural competence requires that organizations:

• Have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally.
• Have the capacity to:
  • value diversity.
  • conduct self-assessment.
  • manage the dynamics of difference.
  • acquire and institutionalize cultural knowledge.
  • adapt to diversity and the cultural contexts of the communities they serve.
  • Incorporate the above in all aspects of policy making, administration, practice, service delivery and involve systematically consumers, key stakeholders and communities.

Cultural competence is a developmental process that evolves over an extended period. Both individuals and organizations are at various levels of awareness, knowledge and skills along the cultural competence continuum.

Linguistic competence - the capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, and individuals with disabilities. Linguistic competency requires organizational and provider capacity to respond effectively to the health literacy needs of populations served. The organization must have policy, structures, practices, procedures and dedicated resources to support this capacity.

Guiding Values & Principles

Organizational

• Systems and organizations must sanction, and in some cases mandate the incorporation of cultural knowledge into policy making, infrastructure and practice.
• Cultural competence embraces the principles of equal access and non-discriminatory practices in service delivery.

Practice & Service Design

• Cultural competence is achieved by identifying and understanding the needs and help-seeking behaviors of individuals and families.
• Culturally competent organizations design and implement services that are tailored or matched to the unique needs of individuals, children, families, organizations and communities served.
• Practice is driven in service delivery systems by client/customer preferred choices, not by culturally blind or culturally free interventions.
• Culturally competent organizations have a service delivery model that recognizes behavioral health as an integral and inseparable aspect of primary health care.

Community Engagement

• Cultural competence extends the concept of self-determination to the community.
• Cultural competence involves working in conjunction with natural, informal support and helping networks within culturally diverse communities (e.g. neighborhood, civic and advocacy associations; local/neighborhood merchants and alliance groups; ethnic, social, and religious organizations; and spiritual leaders and healers).
• Communities determine their own needs.
• Community members are full partners in decision making.
• Communities should economically benefit from collaboration.
• Community engagement should result in the reciprocal transfer of knowledge and skills among all collaborators and partners.

Family & Consumers

• Family is defined differently by different cultures.
• Family as defined by each culture is usually the primary system of support and preferred intervention.
• Family/consumers are the ultimate decision makers for services and supports for their children and/or themselves” (NCCC, 2006).