Cultural & Linguistic Competency in the Workforce: Developing Cross Cultural Communication Skills

1. Cultural & Linguistic Competency in the Workforce:Developing Cross Cultural Communication Skills Presentation Workshop CLC Steering Committee Members: Deborah A. Elliott, MSSW, Eastern State Hospital Nhat Nguyen, MSW, Fairfax Falls Church CSB Competent C.A.R.E. “Culturally Appropriate and Respectfully Engaging” Tuesday, May 4, 2010 Glen Allen, Virginia

2. Question of the Day Why is yogurt good for you?

3. Reference: Pires, S.A., (n.d).

4. Developing Cross Cultural Communication Skills Introduction • Breadth • Learning Outcomes • Working Definitions • Depth • Changing Face of America: Demographics • Scope of Working Definitions • Six Principles of Effective and Successful Organizational Cultural Competency Initiatives • Application • Theory in action - Group activity • Workshop Evaluation

5. Learning Outcomes* • Individual improved cultural communication, awareness of cultural differences, cultural competency (e.g., knowledge and understanding). • Developed a capacity to avoid misunderstandings based on cultural differences and methods for managing relationships (adapted from Buckler, n.d). • Improved ability to work with others as an effective and productive team player. • An improved understanding of current population trends and the impact on professional and personal objectives (Adapted from Buckler, n.d). • Better understanding of “self” (e.g., identity, intrinsic). *Individually measured

6. Cross-Cultural Communication #1: Working Definitions Note: Figure adapted for reference Activity 6: Self-reflective activity (1).( n.d).

7. Cross-Cultural Communication #2:Building the capacity for individual and organizational cultural competency is unique in concept and application. It is important to choose the best direction to achieve an effective end. What factors do individual team players need to consider when working together?

8. Cross-Cultural Communication #3:Organizational Reference: Pires, S.A., (n.d).

9. Cross-Cultural Communication #4: Organizational Policy and Planning Reference: Pires, S.A., (n.d). .

10. Cross-Cultural Communication #5. Managers Reference: Pires, S.A., (n.d). .

11. Cross-Cultural Communication # 6:Working with Others Reference: Pires, S.A., (n.d). .

12. Cultural Competence Continuum Ignorance Sensitivity Competence Awareness Understanding

13. Ignorance Is… the state or fact of being ignorant: lack of knowledge, education, or awareness

14. Changing Face of the United States • Changing demographic • Aging baby boomers • Growth of racial and ethnic minority groups to overtake non-Hispanic White population within the next 45 years • By 2015, non-Hispanic Whites will be primarily elderly population • By 2050, racial and ethnic minority group will account for 90% of the total population growth

15. Cultural Awareness being cognizant, observant, and conscious of similarities and differences among cultural groups

16. Cultural Sensitivity is…. the ability to adjust one’s perceptions, behaviors, and practice styles to effectively meet the needs of different ethnic or racial groups

17. Cultural Competence • 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 and • 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 Reference: DBHDS, 2008

18. Working Definition • 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 (Adapted from Cross et al., 1989) • Culture links individual identities to collective ones

19. Depth: Six Principles of Effective and Successful Organizational Cultural Competency Initiatives* • Community representation and feedback at all stages of implementation • Cultural competency must be integrated into all existing systems of a health care organization • Changes made should be manageable, measurable, and sustainable • Making the business case for undertaking cultural competency initiatives is critical for long-term sustainability • Commitment from leadership is a key factor to success • Ongoing staff training is crucial Source: Wu and Martinez, (2006).

20. Key Point: Conflict • Conflict is neither good nor bad • Conflict is inevitable • Conflict does not have to result in winners and losers

21. Definition of Conflict • Competition by groups or individuals over incompatible goals, scarce resources, or the sources of power needed to acquire them • Competition is also determined by individuals’ perceptions • Disagreement through which the parties involved perceive a threat to their needs, interests or concerns

22. Perception

23. Perception You saw a couple in an intimate love position, right? Interestingly, research has shown that young children cannot identify the intimate couple because they do not have prior memory associated with such a scenario. What they will see, however, is nine (small & black) dolphins in the picture! So, I guess we've already proven you're not a young innocent child. Now, if it's hard for you to find the dolphins within 6 seconds, your mind is SO corrupted that you probably need help! OK, here's help: look at the space between her right arm and her head, the tail is on her neck, follow it up. Look at her left hip, follow the shaded part down, it's another one, and on his shoulder..

24. Visible Part: Ways of life Laws and customs Institutions Rituals Language Hidden Part: Norms Roles Ideologies Beliefs Philosophy Values Tastes Attitudes Assumptions Expectations Myths Iceberg: A Cultural Metaphor ------------------------------------- -------------------------------------

25. Cultural Identities • Culture contains shared characteristics, traits, symbols • Culture emotionally binds collective identity to individual identity • Culture defines potential boundaries between social group

26. Culture • An interconnected way of…sharing with others that gives a sense of belonging • “Culture flows through our lives like underground rivers, powerfully nurturing, potently influencing and sometimes dividing” (Source: LeBaron, 2003).

27. Stages of Development of Intercultural Sensitivity Integration Adaptation Acceptance Minimization Defense Denial 1 2 3 4 5 6 Ethnocentric Stages Ethno-Relative Stages Of resistance To openness

28. What is it? • It is concept that describes a development in an individual of the ability to differentiation cultural forms • Goal: Develop intercultural sensitivity or inter-cultural competence by creating learners capable of transcending traditional ethno-centrism and become ethno-relative • Assumption 1: Individuals are capable of personal growth • Assumption 2: Intercultural sensitivity involves the creation and increasing differentiation of cultural categories • Assumption 3: The way people culturally construct their experiences and interpret their world, or their reality, represents their worldview

29. Intercultural Sensitivity:Denial • An individual in the state of denial doesn’t consider “the other” as relevant • Bennett as the result of two pre-conditions explains how someone could have such underdeveloped categories of difference: Separation and Isolation • Denial is more a naiveté than negativity, but it can devolve into violence, if threatened with abrupt change • Denial can’t be experienced by the oppressed, since they are being denied. Denial may be said to be the luxury of the dominant

30. Intercultural Sensitivity: Defense • In this stage of cultural sensitivity, specific cultural differences are perceived as threatening to one’s sense of reality or identity. Difference is overtly acknowledged; hence this is a development in intercultural sensitivity over denial. One is now aware of others, but this awareness produces an effort to fight the differences in order to preserve one’s worldview, privileges or way of life • Defensiveness takes three forms: Denigration; Superiority; and Reversal. These forms are not mutually exclusive and came be seen interacting in individuals • The defense stage typically carries a heavy affective or emotional baggage with it. The negativity inherent in these three modes of defensiveness, suggest that affectively, hostility, fear, pride, and anger accompany these cultural constructions of difference

31. Intercultural Sensitivity: Minimization • In this stage of ethnocentrism, cultural differences are perceived not as threatening, but as trivial. Instead, cultural similarities are held to be central. The strategy here is to take a position that human similarities are more profound than cultural differences • Minimization takes two forms, physical universalism and transcendent universalism • The affective state of minimization is benign sensitivity and naiveté

32. Intercultural Sensitivity: Acceptance • In acceptance difference is acknowledged and respected. It is a necessary and preferable human condition. The individual respects culturally different behavior • In acceptance difference is respected as it relates to culturally different values. One recognizes different worldviews and assumptions underlying culturally variant behaviors • The affective state accompanying these acceptance constructs might be said to represent the idea of live and let live, or comfort with difference

33. Intercultural Sensitivity: Adaptation • What are the skills needed for effective relating to and communication with people of other cultures? These are additive skills. They are added on top of the way you perceive your cultural identity • One skill is empathy, the ability to experience reality differently than by one’s own culture • A second skill is pluralism: Pluralism here means internalizing multiple frames of reference. Those who live cross culturally live in a manner in which cultural difference is intrinsic to the self. One can speak of a bicultural identity • The affective state associated with adaptation is competence born of the useful skills one has as an intercultural communicant

34. Intercultural Sensitivity: Integration • In this stage of intercultural sensitivity, the individual transcends their indigenous culture. They become a “multicultural person” • Bennett identifies two forms of integration: contextual evaluation and constructive marginality • A fully integrated individual would not have to think of what would be “appropriate” in intercultural circumstances. Their behavior and conversation would reflect comfortable and natural interaction with “others”

35. Cognitive and Affective Responses to Ethnocentric Stages

36. Cross-Cultural Conflict • Occurs cross boundaries • Cognitive • Perceptual • Occurs between individuals or social groups that are separated by cultural boundaries • Individuals within the same society are potential members of many different groups, organized in different ways by different criteria (i.e. subcultures) • Cross-cultural conflicts may occur simultaneously at many different levels

37. Sources of Cultural Conflict • Cultural differences • Pressure to assimilate • Power imbalance • Competing values • Short-term pressures versus long-term pressure • Differing perceptions, values, cultural norms • Ambiguous jurisdictions; lack of clarity; competition for limited resources

38. Cultural Conflict: Chosen Trauma • “Chosen Trauma” by Vamik Volkan • Refer to experiences of great hurt or victimization by others that are part of a group’s historical memory • Symbolizes group’s tremendous threat, fear, pain and feelings of hopelessness • Slavery, Holocaust • Possible responses to psychological trauma: • Agnostic, reactive aggression towards self and others

39. Dealing with Different Languages at Work Assumptions that cause confusion • They’re talking about me • They don’t want to learn English • They know English, they just don’t want to use it

40. Recognizing Responses to Conflict Emotional responses • Feelings we experience • Ranging from anger to fear to despair and confusion • Emotional responses are often misunderstood • Differing emotional responses are confusing and at times, threatening

41. Recognizing Responses to Conflict Cognitive responses • Ideas and thoughts about the conflict • Present as inner voices or internal observers • Through sub-vocalization (self-talk) we come to understand these cognitive responses • Differing cognitive responses contribute to emotional and behavioral responses • Creating negative or positive feedback loops

42. Recognizing Responses to Conflict Physical responses • Ability to meet our needs in the conflict • Heighten stress, bodily tension, increased perspiration, tunnel vision, shallow or accelerated breathing, nausea, and rapid heartbeat • Manage responses through stress management to regulate physical response which helps manage emotional response

43. Resolving Conflicting Needs • Recognition of differing needs • Examine differing needs in an environment of compassionate understanding • Creates pathways to creative problem solving, team building, and improved relationships • Quick and painless resolution of conflicts will foster mutual trust

44. Four Key Conflict Resolution Skills • Quickly Relieve Stress • Recognize and manage ones own emotions • Improve nonverbal communication skills • Use humor and play to deal with challenges

45. Tips for Managing and Resolving Conflicts • Make the relationship the priority • Focus on the present • Pick your battles • Be willing to forgive • Know when to let something go

46. Listen to Resolution • Listen to the feelings and not just the words • Listening tips: • Listen to the reasons the other person gives for being upset • Make sure you understand what the other person is telling you – from his or her point of view

47. Listen to Resolution (continued) • Repeat the other person’s words, and ask if you have understood correctly • Ask if anything remains unspoken, giving the person time to think before answering • Resist the temptation to interject your own point of view until the other person has said everything he or she wants to say and feels that you have listened to and understood his or her message

48. Emotional Intelligence • Skill 1: Quick Stress Relief • Skill 2: Emotional Awareness • Skill 3: Nonverbal Communication • Skill 4: Playful Communication • Skill 5: Conflict Resolution

49. Diversity in TEAMS • Increased diversity in teams • Age, gender, race, language, nationality, etc. • Other cultural differences may also influence the way conflict is addressed

50. Cultural Dimensions • Individualistic Culture • High value on autonomy, initiative, creativity, and authority in decision making • Individual interests supersede group interests • Any group commitment is a function of a perceived self-benefit • Conflict is inevitable and should not be perceived with shame