Culturally Competent Assessments Of Children In Need Social Work Essay
This article critically analyses ‘cultural competence’ as a theoretical construct and explores the need for a framework that will assist social workers to carry out culturally competent assessments of children in need and their families. It is argued that the necessary components of a framework for practice in this area are a holistic definition of culture, an ethical approach to difference, self-awareness, an awareness of power relations, the adoption of a position of complete openness in working with difference and a sceptical approach to a commodified conception of ‘cultural knowledge’. The approach must avoid the totalisation of the ‘other’ for personal or institutional purposes. It is argued that the Furness/Gilligan Framework (2010) reflects these concerns and could be easily adapted to assist with assessments in this area.
Key words: assessment; children in need; children and families; culture; cultural competence
The purpose of this paper is to critically analyse ‘cultural competence’ as a theoretical construct and to explore the need for a framework that will assist social workers to identify when aspects of culture are significant in the lives and children in need and their families. The 1989 Children Act places a legal requirement to give due consideration to a child's religious persuasion, racial origin, and cultural and linguistic background in their care and in the provision of services (Section 22(5)). This provision established the principle that understanding a child’s cultural background must underscore all work with children. However, there has been a longstanding concern that services to children are failing to be culturally sensitive. Concern over the disproportionate number of ‘children in need’ from ethnic minorities led to their specific mention in The Government’s Objective for Children’s Social Services, which states that “the needs of black and ethnic minority children and families must be identified and met through services which are culturally sensitive” (Department of Health, 1999a: para 16). Government policy documents increasingly recognise the multicultural reality of Britain. Yet, government assessment guidance provides practitioners with little assistance in terms of establishing ways in which cultural beliefs and practices influence family life.
Social work has acknowledged the need to respond respectfully and effectively to people of all cultures, ethnic backgrounds, religions, social classes and other diversity factors in a manner that values the worth of individuals, families and communities and protects and preserves the dignity of each (BASW, 2009). There are many indications that culture is significant in determining the ways in which some people interpret events, resolve dilemmas, make decisions and view themselves, their own and others’ actions and how they respond to these (Gilligan, 2009; Hunt, 2005). Practitioners may not, therefore, be able to engage with service users or to facilitate appropriate interventions if they take too little account of these aspects of people’s lives or consider them on the basis of inaccurate, ill-informed or stereotyped ‘knowledge’ (Gilligan, 2009; Hodge et al., 2006).
Culturally competent practice is so fundamental to assessments of children in need that one might expect a well developed literature on the subject. This would act as a robust knowledge base to underpin excellence in service delivery. Thompson (2006, p. 82) admits, “there is a danger that assessment will be based on dominant white norms without adequate attention being paid to cultural differences. Failure to take such differences into account will not only distort, and thereby invalidate, the basis of the assessment but will serve to alienate clients by devaluing their culture.” However, the literature in this area is surprisingly sparse. Almost two decades ago it was described as a “void of published information” (Lynch and Hanson, 1992, p. xvii) and Welbourne (2002) argues that progress is still slow. Boushel (2000) argues that despite the government’s stated concern to know more about the impact of ‘race’ and ethnicity on child welfare, the limited extent to which research reflects the experience and needs of culturally diverse children fails to support a true evidence base for policy or practice. There is evidence that aspects of culture can all too easily be underestimated, overlooked or ignored, sometimes with extremely serious consequences (Laming, 2003; Gilligan, 2008; O’Hagan, 2001). Many mainstream childcare and child protection texts make little reference to culture (O’Hagan, 2001). Not one of the twenty pieces of research into differing aspects of child protection work considered in Messages From Research (Dartington, 1995) explore the cultural aspects of any of the cases dealt with.
There is now a growing body of literature written for health and social care professionals about the importance of developing and incorporating cultural sensitivity and awareness in their work with others (Campinha-Bacote, 1994; CHYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C4"andHYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C4"a HYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C4"andHYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C4" Furman, 1999; Hodge, 2001, 2005; Moss, 2005; Gilligan and Furness, 2006; Sue, 2006; Laird, 2008). However, despite the apparent emergence of a more general recognition and acknowledgement of these issues amongst many professionals, relevant day-to-day practice remains largely dependent on individual views and attitudes (Gilligan, 2009). A Department of Health (2002) study of 40 deaths and serious injuries to children found that, “information on the ethnic background of children and carers was vague and unsophisticated in that it failed to consider features of the child’s culture, religion and race, as specified in the Children Act 1989” (Department of Health, 2002, p. 26). The failure to conceptualize accurately the cultural and social context within which minority ethnic parents are operating impacts on interventions offered, which ‘... served to reflect and reproduce existing powerlessness. . .’ (Bernard, 2001, p. 3). If, as this suggests, there is a deficit in social workers’ ability to conceptualize minority ethnic service users’ social and cultural context in assessments of children, partly accounted for by a paucity of literature in this area, the implications for practice are potentially a failure to carry out culturally competent practice for many vulnerable children.
In The Victoria Climbie Inquiry Report 2003, Lord Lamming commented that, ‘The legislative framework is sound, the gap is in the implementation’ (2003, p. 13). Report after report has expressed concern over the limited skills of social services staff when undertaking assessments and designing interventions with ethnic minority children (Batty, 2002). While many professionals acknowledge that there is a need to work in culturally sensitive ways, there is evidence that many professionals working with children and families do not always feel equipped to do so (Gilligan, 2003). Gilligan (2009) found that whilst professionals may recognise that service users’ beliefs are very important, there is little consistency in how such recognition impacts on practice. Even within his small sample, there was considerable variation in attitudes and much to suggest that actions and decisions are the product of individual choice rather than professional judgement or agency policies (Gilligan, 2009). Practitioners are able to continue with ‘culture-blind’ approaches without these being significantly challenged by agency policies or by professional cultures (Gilligan, 2009). There is a clear need to look again at what we mean by ‘cultural competence’ and to develop a framework that will assist social workers to identify when aspects of culture are significant in the lives and children in need and their families.
There is a clear recognition that aspects of culture are significant in the lives of children and their families and that this needs to be considered in assessment practice. In order to address the lack of understanding and ineffective practice among practitioners in this area it is necessary to provide clear definitions of ‘culture’ and ‘cultural competence’. Assessing children in need and their families is a complex task. There is evidence of considerable variation between social workers’ definitions of the essential components of ‘good enough parenting’, reflecting the variation between professionals in definition of ‘need’ (Daniel, 2000). When reviewing cases of serious injury or death, the Department of Health concluded that: “. . .areas suggested by this research as ripe for ... development [include] reaching common definitions of ‘‘being in need’’ or ‘‘at risk of significant harm’’’ (Department of Health, 2002). It is in this context of ambiguity that ‘culture’ must be defined. The 1989 Children Act uses the wording ‘culture’ as a statutory requirement in addressing the needs of black children, but does not offer guidance about its definition.
Culture is a highly discursive term and the object of an intensive theoretical and political dispute (Benhabib, 1999, 2002). The construction of culture as a theoretical concept has always been affected by entangled perspectives, particularly in social work (Boggs, 2004). Harrison and Turner (2010) found that participants in their study spent considerable time discussing the complex nature of culture and the difficulties in defining it. This means that when looking at the practice of cultural competence as part of assessing need and risk the scope for conceptual ambiguity is vast (Welbourne, 2002).
Eagleton (2000, p. 1) states that, “culture is said to be one of the two or three most complex words in the English language”. O’Hagan (2001) argues that culture is a complex concept, with virtually limitless parameters, which cannot be defined or explained in the two or three sentences usually allocated to them in much health and social care literature. For example, Payne (1997, p. 244) provides a rather ambiguous definition of culture: “a difficult concept. It implies a relatively unchanging, dominating collection of social values, and assumes that members of an identified group will always accept these”. It is possible to examine definitions of culture that stem from anthropology, sociology, psychology and cultural geography (O’Hagan, 2001). The anthropologist Edward Tylor (1871) formulated the most enduring definition of culture: “culture... is that complex whole which includes knowledge, beliefs, art, morals, law, custom and any other capabilities and habits acquired by man as a member of society”. The sociologist Giddens (1993: 31) says that culture “refers to the ways of life of the members of a society, or of groups, or within a society. It includes how they dress, their marriage customs and family life, their patterns of work, religious ceremonies and leisure pursuits”. O’Hagan (2001) defines culture as “the distinct way of life of the group, race, class, community or nation to which the individual belongs. It is the first and most important frame of reference from which one’s sense of identity evolves”. O’Hagan’s definition draws on anthropology and is wide enough to challenge essentialist notions of culture, yet defined enough to be meaningful. It also balances the community and individual aspects of culture. When we consider this definition of culture it can be seen that all assessment of children in need occurs within a cultural context. In fact it is perhaps better understood as taking place within a number of interacting cultural contexts, with the culture of the child at the heart of the process.
The use of the concept of ‘culture’ in developing ‘cultural competence’ and not ‘race’ has been a deliberate shift in terminology from anti-racist theorising. Anti-racist theory, with its emphasis on race, has been criticised for dichotomising ‘blackness’ and ‘whiteness’ which does not permit any differentiation in the experience of racism between different ethnic groups (Laird, 2008). The idea of racial homogeneity has been enduring but this idea must be challenged. White people and black people are not homogeneous groups (Laird, 2008). Culture is a broader term than ‘race’ or ‘ethnicity’ and can include aspects of age, gender, social status, religion, language, sexual orientation and disability (Connolly, Crichton-Hill and Ward, 2005). Using the term ‘culture’ allows for difference of attitude and experience between individuals who are part of the same ethnic or racial grouping. If one considers that culture is learned from generation to generation, it is inevitably person specific and shaped by one’s personal and societal context.
The Challenge of Cultural Competence
There are a variety of paradigms in the study of race, ethnicity and culture which are located in particular socio-historical and political contexts. ‘Cultural competence’ is just one of these and has not escaped criticism in the professional literature. Writers in social work have argued that cultural competence depoliticises race relations and promotes ‘othering’ (Pon, 2009), assumes workers themselves are from a dominant culture (Sakamoto, 2007) and is based on the flawed assumption that acquiring cultural knowledge will result in competent practice (Dean, 2001; Ben-Ari and Strier, 2010). Despite its wide acceptance, the concept remains subject to multiple, often conflicting, views. There is a need to critically analyse ‘cultural competence’ as a theoretical construct in order to make it meaningful to practitioners and to provide a basis for best practice.
Concern with racism emerged in the social work profession in the 1970s and during the 1980s major texts appeared to guide practice (Payne, 2005). The concept of ‘anti-racist’ practice emerged built on the principles that ‘race’ is a social construct that has been used to justify oppression and that it is necessary to critically examine the dynamics of power relationships that produce oppression. Anti-racist theorists have criticised advocates of cultural competence for creating an ‘exotic’ understanding of people from ethnic minorities and for not recognising practice issues of social inequality or racial discrimination (O’Hagan, 2001). Cultural competence has been presented as apolitical and has been criticised for failing to address the power struggles of history (Barn, 2007). Key issues of power are absent from much of the analytical thinking around the paradigm of cultural competence (Barn, 2007). Given that the political, cultural and professional perspectives on race and ethnicity have important consequences for minority ethnic children and families, social workers need to incorporate an understanding of power relations as a key tool for subverting racism. A more sophisticated and nuanced approach is necessary, which will involve a paradigm shift from essentialist notions of race which view culture in rigid and inflexible ways to one in which cultural sensitivity is understood within the context of power relations (Barn, 2007). It is important to widen the debate beyond ‘black’ and ‘white’, to recognise that racial, ethnic and cultural groups are not homogenous, but to not abandon the challenging of racism and other forms of oppression.
Culturally competent practice needs to take account of the tensions between different cultural norms and values within the UK, not only between ethnically and culturally distinct groups of people. Social work norms and values may not be those of the majority of Europeans, or even of the ‘mainstream’ white UK population, as the case of A v UK demonstrates. Writers such as Olsen (1981), Korbin (1981, 1991) and Thorpe (1994) have problematised the notion of a universal standard of childcare, pointing to significant cross-cultural variability. The essence of this challenge is that standardized definitions of child abuse must be contested as they necessarily relate to culturally defined norms. Korbin HYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/35/6/901?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=how+and+when+does+athnicity+matter&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#KORBIN-1991"(1991), in what is now a classic essay, warns against the dangers of both Eurocentric practice and overly culturally relativist practice.
On the one hand, Eurocentric practice serves only to impose one set of cultural beliefs and practices as preferable and therefore reproduce patterns of domination and oppression. In the British literature, concern has been expressed that minority families are too frequently pathologised and stereotyped, with workers over-relying on cultural explanations for their problems and utilizing a model of cultural deficit (Williams and Soyden, 2005; Chand, 2000; Ahmed, 1994). It is argued that they receive more and speedier punitive services than preventative/care services (Williams and Soyden, 2005). Lees (2002) argues from her research that there is a tendency to ‘pathologise’ behaviour that is not culturally ‘normative’, an example being negatively evaluating the act of running away from an abusive home among young black women rather than adopting passive coping strategies.
At the other extreme, Korbin notes “... extreme cultural relativism, in which all judgements of humane treatment of children are suspended in the name of cultural rights, may be used to justify a lesser standard of care for some children” (1991, p. 68). It has been suggested that cultural relativism ‘freezes the status quo’ by making standard-setting according to ‘universal’ norms impossible (Laird, 2008). Barn et al (1997) found that adoption of a position of cultural relativity through fear of being labelled as racist affected statutory provision to children and families. They found that some social workers were reluctant to intervene to protect children because they believed that abusive behaviour was sanctioned by their culture (Barn et al, 1997). The child abuse inquiry reports of Jasmine Beckford (Blom-Cooper, 1985) and Tyra Henry (Lambeth, 1987) concluded that ‘culture’ had impinged upon events leading to the deaths of these children. It was suggested that workers were too optimistic in their assessments of carers and that abusive behaviours were interpreted as aspects of culture.
Whilst these concerns turn on the recognition of aspects of cultural difference as significant in the process of assessment, it has long been noted in the social work literature that practitioners fail at the first hurdle, in as much as they do not recognise at all the importance of culture: a culture-blind approach (Dominelli, 1998; Boushol, 2000; Graham, 2002). The culture-blind approach eschews difference in its search for a universal formula. It suggests that a standard of good practice can be established which fits all. For example, Payne (1997) rejects the argument that western social work theory may be incompatible with some of the core components of other cultures and ignores the fact that it was used extensively in the processes of annihilation of various indigenous cultures (O’Hagan, 2001). Despite being consistently criticised as naive and oppressive, this approach represents a powerful paradigm within social work (Williams and Soyden, 2005; Dominelli, 1998).
Finding the balance between these concerns poses considerable difficulties for those charged with assessments of children in need (Dominelli,HYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/35/6/901?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=how+and+when+does+athnicity+matter&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#DOMINELLI-1998A" HYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/35/6/901?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=how+and+when+does+athnicity+matter&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#DOMINELLI-1998A"1998). What is needed is an approach to practice that can challenge normative stereotypes of ‘appropriate’ behaviour by parents or children while promoting the rights of children to safety and ‘good enough’ parenting. Brophy (2003, p. 674) states “Balancing a respect for differing styles of parenting and guarding against inappropriate inroads into lifestyles and belief systems, while also protecting children from ill-treatment, remains an exacting task. Professionals can be castigated for intervening too quickly or too slowly.” Social workers must operate with cultural sensitivity within the assessment process but at the same time recognize that at the heart of anti-oppressive practice is a commitment to the non-relative core value of human equality.
A Knowledge Based Competency?
Cultural competence as a practice response to these issues has been conceptualised in several ways. There are not one, but multiple definitions of cultural competence and it appears to be a changeable, evolving concept (Harrison and Turner, 2010). The frameworks available to assist practitioners in assessing aspects of culture are predominantly of two types: assessment models that try to aid in the collection of information and the understanding of specific service users' strengths, needs and circumstances (Carballeira, 1996; Hodge, 2001, 2005; Hogan-Garcia, 2003; Sue, 2006) and reflective models that aim to help the practitioner to develop relevant skills and awareness in general terms (Green, 1999; Connolly, Crichton-Hill and Ward, 2005; Papadopoulos, 2006).
Assessment models of cultural competence frequently refer to the integration and transformation of knowledge about individuals and groups of people into specific standards, practices and attitudes used in appropriate cultural settings to increase the quality of services, thereby producing better outcomes (Davis and Donald, 1997). To work effectively with diversity, practitioners are expected to gain knowledge of different cultural practices and worldviews, to have a positive attitude towards cultural differences and develop cross-cultural skills (Ben-Ari, 2010). Examples of assessment models include the LIVE and LEARN Model developed by Carballeira (1996) which identifies a series of activities which practitioners need to engage in to be culturally competent: Like; Inquire; Visit; Experience; Listen; Evaluate; Acknowledge; Recommend and Negotiate. Another example is Campinha-Bacote’s (2002, pp. 182-3) ASKED model which identifies five dimensions of cultural competence: cultural Awareness; cultural Skill; cultural Knowledge; cultural Encounter; and cultural Desire. In line with this approach Sue (2006) argues that “culturally competent social work practice is defined as the service provider’s acquisition of awareness, knowledge, and skills needed to function effectively in a pluralistic democratic society” (2006: 29).
However, there is disparity in the literature as to the ‘knowledge’ that is necessary for effective culturally responsive practice. The above models adopt a cultural literacy approach in which culture specific information and practice is categorised under broad ethnic group categories (Connolly, Crichton-Hill and Ward, 2005). For example, Laird’s (2008) book “Anti-Oppressive Social Work” contains chapters entitled “communities with roots in India”, “communities with roots in the Caribbean” and “communities with roots in China”. Similarly, O’Hagan (2001) includes chapters about “Islam”, “American Indians” and “Australian Aborigines” in his book about cultural competence. Laird (2008, p. 156) states “It is only by gaining cultural knowledge, that is, learning to appreciate the variety of ways in which people with different heritages organise their lives, that practitioners from the white-majority community can gain cultural awareness. This is because cultural knowledge... offers practitioners a comparative analytical tool with which to examine cultural influences upon their own lives”.
From this approach ‘knowledge’ is seen as central to the development of cultural competence skills, which are fundamentally knowledge-based learned capacities (Ben-Ari and Strier, 2010). It is widely believed that cultural knowledge is the key to interpreting the code of cultural diversity (Ben-Ari and Strier, 2010). It is argued that without knowledge, one cannot be aware of the presence of biases in professional practices and practice could remain ethnocentric (Adams et al., 2001). There is a tendency to think that if a worker learns about a culture, what Spradley (1994) calls ‘explicit cultural knowledge’, then they will have a framework for working with that culture. Widely existing conceptions of cultural competence assume that the ‘other’ is knowable and that this knowledge is a prerequisite for being culturally competent (Ben-Ari and Strier, 2010).
A radically different stance has been suggested by Ben-Ari and Strier (2010) who examine cultural competence through the lens of Levinas (1969) theory of ‘other’. Levinas (1969) proposes that ethics precedes knowledge. He argues that our humanity is realised through the ‘wisdom of love’ and not through the ‘love of wisdom’ (the literal Greek meaning of the word ‘philosophy’). In other words, ethics precedes any objective searching after truth (Beals, 2007). Levinas' thesis ‘ethics as first philosophy’ means that the pursuit of knowledge is but a secondary feature of a more basic ethical duty to the ‘other’. Within this framework, the main question becomes what relation to the ‘other’ is necessary in order for knowledge to be possible? He argues that the ‘other’ is not knowable and cannot be made into an object of the ‘self’, as is done by traditional philosophy. By emphasising the primacy of ethics to knowledge, Levinas creates a new framework for working across differences.
This raises fundamental questions with regard to the nature of social knowledge. Laird (2008) argues that the most critical requirement of culturally sensitive social work is to keep open the dialogue between people from different ethnic backgrounds and to ensure that each individual emerges as a unique composite of values, beliefs and aspirations. It is necessary to consider how accumulated knowledge about ‘other’ cultures has the potential to limit our openness in our encounters with people who are ‘other’ to us. Knowledge about other cultures can lead to the experience of totality: something is nothing more than what I make out of it (Ben-Ari and Strier, 2010). When we totalise the ‘other’ we reduce our understanding of it. Levinas (1987) proposes that we should aim for the experience of infinity, that is, the recognition that something is more than what we could make of it. Berlin (2002, p. 144) notes the danger of totalising people from other cultures, stating “classifying people on the basis of group membership only gives us the illusions that we are being culturally sensitive, when, in fact, we are failing to look beyond easy characterisations for the particular and specific ways this person is understanding, feeling and acting”. A knowledge based approach to cultural competency has a tendency to create overgeneralisations of cultural groups and can lead to the worker perceiving themselves as an ‘expert’ despite the likelihood of them being in a position of cultural naivety (Connolly, Crichton-Hill and Ward, 2005).
The implication of this is that culturally competent assessments must come from an ethical standpoint of openness on the part of the practitioner. O’Hagan (2001) states, “The workers need not be highly knowledgeable about the cultures of the people they serve, but they must approach culturally different people with openness and respect”. It must be recognised that thoughts, feelings and actions are influenced by external and internal variables that are cultural in origin and, as a consequence, that each individual who enters the child welfare system is unique (Connolly, Crichton-Hill and Ward, 2005). A consequence of this is that perceptions of the child welfare problem will be unique to each client or family. Understanding how the family perceives the problem enables child protection workers to work in a more culturally responsive way in developing solutions. Cooper (2001, p. 732) states “the meanings in context of a child’s injury are not ‘revealed’ through objective facts or through ‘expert’ objective assessment or diagnosis. An agreed meaning, understanding and potential for change can only be co-constructed, with the service user and their social relationships and networks, within a situated organisation and multi-agency context”. Aligning solutions with the cultural identity of the family provides the potential for family-centred responses. Cultural competence must move away from an emphasis on ‘cultural knowledge’ if it is to provide an ethical framework for working with difference.
A Matter of Reflection?
The second main type of cultural competence model is a reflective model. Reflection has been part of practice discourse for a number of decades (Schon, 1983; 1987). More recently the concept of critical reflection has taken hold (Fook, 2002). A critically reflective response challenges the values and attitudes associated with professional conduct (Connolly, Crichton-Hill and Ward, 2005). An example of a reflective model of cultural competence is the ‘cultural-reflective model’ developed by Connolly, Crichton-Hill and Ward (2005). This model includes the processes of cultural thinking; critical reflection and reflective practice outcomes. A strength of the model is that is recognises the interaction between the ‘self’ and the ‘other’ within interactions between people of different cultures.
Ben-Ari and Strier (2010) argue that the development of the concept of ‘cultural competence’ could benefit from considering the significance of ‘self’ and ‘other’ interdependence in contemporary debates on cultural diversity. They analyse relations between ‘self’ and ‘other’ using Levinas’ theory of ‘other’ and explore the ways in which these relations play a pivotal role in working with differences. A person's definition of the ‘other’ is part of what defines the ‘self’ (Levinas, 1969). The idea that the ‘self’ requires the ‘other’ to define itself has been expressed by many writers (Brown, 1995; Riggins, 1997; Gillespie, 2007). It has been recognised that the concept of ‘otherness’ is integral to the understanding of identities as people construct roles for themselves in relation to an ‘other’.
The implication of this is that that all cross-cultural encounters between social workers and service users bring into play not only the heritage of the service user, but also that of the practitioner (Laird, 2008). Connolly, Crichton-Hill and Ward (2005, p. 59) note that “assessments of the social world are likely to say more about the perceiver than the persons under study”. Social workers need to discover and reflect upon their own value system and traditions in order to be culturally competent. Reflective models, such as Connolly, Crichton-Hill and Ward’s (2005), recognise that our cultural thinking responses are often automatic and outside of our control. It is necessary to ask where our responses and language come from (Connolly, Crichton-Hill and Ward’s, 2005). The reflective process encourages an examination of values and beliefs underpinning reactions. It involves challenging our assumptions, recognising stereotypes and recognising power and its effects. Without this it is easy to think that it is our way of being is the norm and other people who are “ethnic, idiosyncratic, culturally peculiar” (Eagleton, 2000, p. 26). Connolly, Crichton-Hill and Ward (2005, p. 29) note that “being so familiar, our own way of thinking and our own way of life can so easily seem ‘simply human’ to us”. O’Hagan (2001: 262) states “cultural competence emerges from rigorous self-exploration; it expands the professional’s empathic repertoire, ensuring there is no culturally biased instant response”. It is self-awareness and an ethical stance of openness that are the most important components of cultural competence, not accumulated knowledge of the ‘other’.
Developing a Framework for Practice
Having re-conceptualised the essential components ‘cultural competence’ it is necessary to consider what implications this has for practice in the area of assessments of children in need and their families. Any implications have to consider the policy and organisational context that assessments of children take place within. The policy that underpins assessment in this area is The Framework for the Assessment of Children in Need and Their Families (The Assessment Framework) (Department of Health, 2000b). The Assessment Framework was issued as guidance under the Local Authority Social Services Act 1970, which means that it must be followed by local authorities unless there are exceptional circumstances that justify a variation. The Assessment Framework represents a way of capturing the complexity of a child’s world and an attempt to construct a coherent approach to collecting and analysing information about a child (Rose, 2001). The framework is underpinned by an ecological approach, meaning practitioners completing an assessment consider three ‘domains’: the developmental needs of individual children; parenting capacity; and family and environmental factors. Each ‘domain’ is further divided into ‘dimensions’ that indicate key areas that should be considered for that particular domain.
The Assessment Framework states, “differences in bringing up children due to family structures, religion, culture and ethnic origins should be respected and understood. . .every effort should be made to ensure that agencies’ responses do not reflect or reinforce that experience [daily experience of discrimination] and indeed, should counteract it... Ensuring equality of opportunity does not mean that all children are treated the same. It does mean understanding and working sensitively and knowledgeably with diversity to identify the particular issues for a child and his/her family, taking account of experiences and family context” (Department of Health, 2000b, p.12). However, the attention given to aspects of a child’s culture within the Assessment Framework is very limited. If a practitioner uses the Assessment Framework without making reference to the accompanying guidance, as appears to frequently be the case (Horwath, 2002), it would be easy to interpret the influence of culture on family life in a very narrow way. The Practice Guidance accompanying the Assessment Framework notes that “. . .although many professionals are aware that it is essential to take account of race and culture, and in particular to be culturally sensitive in their practice, they are often at a loss to translate this into practical terms” (Department of Health, 2000a, p. 38).
Whilst recognition of issues of culture in assessments of children has had a growing body of literature, the limited extent of empirical research in this area fails to bolster evidence-based policy making and potentially signals a failure to carry out culturally competent assessment for ethnic minority children (Boushol, 2000; Welbourne, 2002). There is little empirical evidence to demonstrate that the principle of cultural sensitivity and awareness guides practitioner decision making, or to verify the claim that it benefits ethnic minority clients (Williams and Soyden, 2005). Williams and Soyden (2005) carried out a cross-national study that examined these concerns within the context of child protection. Their study demonstrates that despite variations in national policies the child’s ethnic affiliation evokes little significant response by social workers regardless of the country, confirming a largely universalist approach (Williams and Soyden, 2005). Overall, their findings suggest that the logic of universalism continues to mitigate against the significant acknowledgement of ‘difference’ in assessments of children (Williams and Soyden, 2005). This highlights a clear need to develop a framework to assist practitioners in assessing aspects of culture when carrying out assessments of children in need and their families.
It is unrealistic to expect practitioners to conduct separate assessments of issues arising from culture (Furness and Gilligan, 2010). Any additional assessments are likely to be unwelcome to service users, many of whom tell researchers that they undergo too many already (Furness and Gilligan, 2010; Dartington Social Research Unit, 2004). Harrison and Turner (2010) found that deadlines and time constraints were considered to be impediments to culturally competent practice and practice responses have to be aware of these issues. There is tension between attempting to provide culturally competent practitioners within stressful, under resourced public systems (Connolly, Crichton-Hill and Ward, 2005). Therefore, any suggested framework for cultural competence in assessing children in need and their families has to be compatible with the Assessment Framework’s (Department of Health, 2000a) recording forms and timescales.
It has been established that the necessary components of a framework for practice in this area are a holistic definition of culture, an ethical approach to difference, self-awareness, an awareness of power relations, the adoption of a position of complete openness in working with difference and a sceptical approach to a commodified conception of ‘cultural knowledge’. To achieve this it seems essential that practitioners are not limited by a procedural model of assessment, but are free to ask appropriate open-ended questions, in order to allow people to express themselves in ways that they choose, are familiar to them and respect their expertise. It is also important to recognise that beliefs and practices will vary even amongst those within the same cultural grouping. A variety of daily living activities may be profoundly influenced by a person's culture and may, therefore, require exploration with them: race and ethnicity; language; religion and spirituality; modesty and privacy; clothing, jewellery and make-up; washing and hygiene; hair care; prayer; holy days and festivals; physical examination; birth; contraception; abortion; attitudes to death, dying and mourning; medication; healing practices; transfusions, organ donation and transplant; last offices; post-mortem and funeral services (HusbHYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C36"andHYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C36" HYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C36"andHYPERLINK "http://bjsw.oxfordjournals.org/cgi/content/full/bcp159v2?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=social+work+religion+and+belief&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT#BCP159C36" Torry, 2004). Discussion of these issues may inform the assessment in significant ways.
Gilligan and Furness (2010) have developed a framework with the aim of assisting practitioners to reflect on and assess the relevance of their own religious beliefs and those of service users in assessments. The framework consists of eight key questions to aid practitioners (Gilligan and Furness, 2010) (see Figure 1). This framework, which follows broadly person-centred and strengths-based approaches (Rogers, 2003; Saleeby, 2008), has been piloted with social work students and refined through feedback and application. The framework was developed to be integrated into the most frequently used existing frameworks for assessment, including the Framework for Assessment of Children in Need and their Families (Department of Health, 2000b).
Questions one to seven of the framework (Gilligan and Furness, 2010) represent an approach that incorporates the essential aspects of an ethical approach to cultural competence outlined above and could easily be adapted in order to assist with culturally competent assessments more widely (See Figure 2). If the eighth key question is removed, this framework also avoids the totalisation of the ‘other’ through an inappropriate use of ‘cultural knowledge’. The practitioner needs to begin with a holistic definition of culture as discussed above and adopt a critically reflective approach, considering power relations and their implications.
This approach to working with cultural diversity implies, first and foremost, an ethical relation to difference. The reflective approach of the model avoids the totalisation of the ‘other’ for personal or institutional purposes. The recognition that differences cannot be fully known means that we are aware that they are always more than what we grasp. Ben-Ari and Strier (2010) believe that expanding our understanding of Levinas' ethical stance, which utterly advocates the replacement of knowledge with responsibility, is a promising lead in this direction. It is not only that knowledge is not enough, but that under certain conditions, it can even be harmful. Finally, this model does not detach working with differences from an anti-oppressive perspective assuming social responsibility towards the excluded and oppressed (Dominelli, 2002; Danso, 2009).
Clearly there would be a need to empirically research the usefulness and effectiveness of such a framework for considering aspects of culture in assessments of children in need and their families, which would need to consider the organisational context within which such assessments take place. 87.5 per cent of participants in Gilligan and Furness’ (2010) pilot of their framework said that it had been and would be helpful in their assessments. However, the fact remains that such a framework adopts an ethical stance towards difference in culture.
To fully appreciate and engage with matters relating to culture when assessing children in need and their families is not easy and a balance needs to be struck between positions of Eurocentric practice and overly relativistic practice. It has been argued that the necessary components of a framework for practice in this area are a holistic definition of culture, an ethical approach to difference, self-awareness, an awareness of power relations, the adoption of a position of complete openness in working with difference and a sceptical approach to a commodified conception of ‘cultural knowledge’. The approach must avoid the totalisation of the ‘other’ for personal or institutional purposes. It has been argued that the Furness/Gilligan Framework (2010) reflects these concerns and could be easily adapted to assist with assessments in this area. Underestimating or ignoring the place of culture can result in the loss of opportunities to make real differences and improvements in the lives of service users, while inaction could, on occasion, lead to serious harm. Competent practitioners need to put aside their own prejudices and to remain open and receptive to the needs of all service users. In the present climate, it can be difficult for busy practitioners to find time for reflection and personal development. However, this is vital if social workers are to work effectively within a culturally diverse society.
Figure 1: Furness/Gilligan Framework: Principles for Reflection on Religion and Belief
1. Are you sufficiently self-aware and reflexive about your own religious and spiritual beliefs or the absence of them and your responses to others?
2. Are you giving the individuals/groups involved sufficient opportunities to discuss their religious and spiritual beliefs and the strengths, difficulties and needs which arise from them?
3. Are you listening to what they say about their beliefs and the strengths and needs which arise from them?
4. Do you recognise individuals' expertise about their own beliefs and the strengths and needs which arise from them?
5. Are you approaching this piece of practice with sufficient openness and willingness to review and revise your plans and assumptions?
6. Are you building a relationship which is characterised by trust, respect and a willingness to facilitate?
7. Are you being creative in your responses to individuals' beliefs and the strengths and needs which arise from them?
8. Have you sought out relevant information and advice regarding any religious and spiritual beliefs and practices which were previously unfamiliar to you?
Figure 2: Adapted Furness/Gilligan Framework: Principles for Reflection on Aspects of Culture
1. Are you sufficiently self-aware and reflexive about your own cultural identity and your responses to others?
2. Are you giving the individuals/groups involved sufficient opportunities to discuss their cultural attitudes and beliefs and the strengths, difficulties and needs which arise from them?
3. Are you listening to what they say about their culture and the strengths and needs which arise from it?
4. Do you recognise individuals' expertise about their own culture and the strengths and needs which arise from them?
5. Are you approaching this piece of practice with sufficient openness and willingness to review and revise your plans and assumptions?
6. Are you building a relationship which is characterised by trust, respect and a willingness to facilitate?
7. Are you being creative in your responses to individuals' cultures and the strengths and needs which arise from them?
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