“I don't know what to do—Could it be cultural?” The operationalization of cultural sensitivity among street‐level workers in the Norwegian Labour and Welfare Administration

Faced with increased global migration and a more ethnically diverse clientele, several studies stress the need for more culturally sensitive welfare services. Others warn that the focus on culture might lead to the culturalization and othering of clients from ethnic minority or migrant backgrounds. In the Norwegian context, cultural sensitivity is implemented in policy documents of the Norwegian Labour and Welfare Administration (NAV) to improve services for immigrant clients. However, the operationalization of cultural sensitivity into service delivery remains unscrutinized. Based on ethnographic fieldwork at a frontline NAV‐office, this article unpacks the practical work embedded in being culturally aware, by exploring the circumstances in which street‐level workers factor culture into their comprehension and consideration of a case. The article employs a process‐oriented approach to its analysis of caseworkers' discussion of cases. Findings show that caseworkers explicitly consider culture mainly when cases appear diffuse and intangible. The caseworkers discuss plausible explanations to make sense of these cases, only one of which is culture. Thus, the caseworkers distinguish culture from the client's ethnicity or migrant background. These findings refine the perception of street‐level workers' inability to respond to questions of ethnicity and culture, by describing the dynamic processes of implicit categorization and sensemaking embedded in being aware of culture. The study also highlights the importance of empirical, ethnographic accounts to unpack the operationalization of such theoretical and ambiguous concepts into practice.     

Culturally Competent Approaches for Counseling Urban Appalachian Clients: An Exploratory Case Study

ABSTRACT

The authors examine the application of a strengths-based empowerment approach to working with an urban Appalachian woman and her family. The purpose of this article is to start the research process by utilizing the lessons learned to assist health and human service practitioners. Key points are identified in developing awareness and intervention skills when working with clients who have an Appalachian cultural heritage. This case study utilizes a culturally competent framework for assessing and intervening with Appalachian clients that emphasizes the strengths and empowerment literature. As the foundation for further research, this case study provides a rationale for starting evidence-based practice incorporating a strengths-based empowerment theme. Case study research is limited by its focus on one individual within a specific span of time and cultural context; findings cannot always be generalized to a similar population. Suggestions for further research in this area are provided.     

Bilingual Social Workers in Mental Health Service Provision: Cultural Competence,Language, and Work Experience

Many agencies actively recruit bilingual social workers. This study presents the reactions of 10 Chinese bilingual social workers to the expectations and demands of their agencies. The study employed a qualitative design with a phenomenological approach. The participants’ responses provide insight into how they manage ethnic and cultural mental health issues in Chinese populations. This study aims to improve social service delivery for clients with limited English proficiency by identifying effective, culturally competent services. The findings suggest that when hiring bilingual social workers, it is just as important for them to be culturally competent as it is for them to be an ethnic or language match with the client base. Having all of these qualities will result in staff members who can provide more effective services by making accurate diagnoses and identifying appropriate treatment plans. In addition to employing bilingual social workers, it is important to maintain good supervision as this will allow supervisees to have a unique perspective on what is involved in providing effective delivery of services to clients with limited English proficiency. Implications for research, practice, and policy are discussed.     

Spiritual Assessment and Latter-Day Saints: Establishing the Preliminary Validity of Spiritual Eco-Maps

ABSTRACT

Few spiritual assessment approaches have been validated with Latter-Day Saints (LDS), in spite of the importance of religion to this culturally distinct population and its burgeoning growth. Drawing on the concept of social validity, this mixed-method study validates a qualitative spiritual assessment approach—spiritual eco-maps—using a geographically diverse sample of social workers (N = 100), all of whom had at least 5 years of direct practice experience with LDS clients. These individuals were asked to identify: a) the degree of cultural consistency, strengths, and limitations of the spiritual eco-map at a conceptual level; and 2) how the questions designed to operationalize the approach might be improved to be more valid, relevant, and consistent with LDS culture. The results suggest that spiritual eco-maps are consistent with LDS culture as long as they are operationalized appropriately. Toward this end, a culturally valid question protocol is provided along with suggestions for administering the instrument in a culturally competent manner. Spiritual eco-maps may be particularly useful in settings where a quick, visually oriented assessment that focuses on clients’ present relationships is indicated. Future research might build upon the present study by assessing the validity of spiritual eco-maps with both community and client samples.     

The grief process in physical illness 1

Abstract

Constructivism, a view that we cannot know reality apart from our constructions of it, along with social constructionism, a belief that knowledge is socially, historically, and culturally situated, form the basis of a new approach to clinical practice. In the explication of this perspective, assessment is defined as a collaborative inquiry. Multiple theoretical perspectives are used as viable alternative explanations, with no single perspective privileged. In treatment, clients’ narratives are emphasized and meaning is co‐constructed. The therapeutic relationship is construed as reciprocal, with more attention given to the client's perceptions. Values have a central role in treatment.     

“They tippy toe around the race issue”: The impact of a Title IV‐E program on culturally informed practice for child welfare students

This study examines changes in MSW students' perceived cultural competence across 11 child welfare practice skills before and after participation in a University's Title IV‐E program and explores students' perceptions of cultural competency and cultural humility. The findings indicate modest gains across all 11 practice skills; however, focus group interviews revealed that students do not necessarily feel prepared to conduct culturally competent practice with children and families. A culturally informed practice in public child welfare is discussed and includes training implications for Title IV‐E programs.     

The Social Work Assessment Tool (SWAT)

Abstract

This paper reports on the last of three National Hospice and Palliative Care Organization initiatives to move hospice and palliative care social workers into the patient/family outcomes arena: the development of the Social Work Assessment Tool. The experience of a team of practitioners and researchers is described, including results of two pilot studies and subsequent SWAT revisions. The major focus is on the current model performance improvement project, in which 19 social workers from 14 hospice and palliative care programs used the SWAT with 101 patients and 81 primary caregivers for a median of 44 days. Quantitative analysis indicated significant improvement in SWAT scores for patients from the first to the second social work visit (t = ?2.60, df = 47, p .01). Qualitative interviewing of the social workers indicated some lack of readiness in the field to conduct quantitative outcomes measurement. Additional measures are needed in addition to the SWAT, including qualitative measures, and measures of mezzo and macro practice. Participants indicated that the SWAT was appropriate for use with economically and culturally diverse clients.     

Cultural case workers in child disability services: an evidence-based model of cultural responsiveness for refugee families

The medical/disabled category for quota refugees selected for resettlement in New Zealand allows entry to those who have either a medical condition that can be treated or helped in New Zealand or a disability that requires support. Children from refugee and other culturally and linguistically diverse backgrounds with impairments comprise an increasing proportion of the caseloads of Auckland region child health and disability services. For people from refugee backgrounds, the New Zealand disability system can be complex, difficult to understand and hard to navigate. Disability therapeutic, rehabilitative and support services are often non-existent in countries of origin. The interventions offered in western countries such as physiotherapy, occupational therapy and speech language therapy may be unknown and therefore poorly understood by refugee clients and families. This article presents the findings of an evaluation of the establishment of cultural caseworker positions in the Waitemata District Health Board Child Development Service.     

Students' of Color and European American Students' Stigma-Relevant Perceptions of University Instructors

In classrooms students of color may experience stigma (i.e., concern about being stereotyped) because negative stereotypes of their intellect are salient. Two studies included African American, European American, and Latina/Latino female and male undergraduates. Study 1 ( n = 86) demonstrated while students of color generally had positive expectations of teachers, their expectations declined when imagining class with a European American instructor who would repeatedly versus never evaluate their work or an ethnically matched instructor across conditions. Study 2 ( n = 136) revealed all students had more positive expectations of culturally tolerant versus culturally intolerant instructors. Students of color more than European American students perceived that intolerant instructors could grade them unfairly. We discuss implications for ethnically diverse classrooms .     

Trial and error: attending to language barriers in child welfare service provision from the perspective of frontline workers

This paper reports on a qualitative study that used focus groups to gather data from the perspective of child protection workers on their experiences in providing services to clients with limited English proficiency (LEP). The goals of the study were to understand processes of relationship building and service provision that could contribute to improved practice. Focus groups are ideal in obtaining data on how a group deals with particular situations and for understanding their decision‐making processes. Measures to ensure rigour and trustworthiness were taken throughout the study. Findings provide rich and multilayered insights into the complexity of providing services for families with LEP showing that agencies use bilingual workers as well as interpreters for services. Participants noted, however, that services continued to be inconsistent with unclear guidelines and training about how and when to access interpreters. Lack of training for bilingual workers was also identified. Confidentiality issues, barriers to engaging with clients, problems with the quality of interpretation and role confusion together with benefits including interpreters being cultural and language ‘conduits’ and links to culturally specific services; enhanced communication decreasing the possibility of inaccurate assessments and lessening power differentials; and help with workload were noted.     

从“志在富民”到“文化自觉”:费孝通先生晚年的思想转向

本文是对费孝通先生晚年思想转向之成因的研究。费孝通晚年的研究强调理论与实践并重,力倡"文化自觉",由早年注重西方文化变而偏重于中国传统文化。通过对费孝通晚年著作的详细考察,本文认为,费孝通的思想转向是他在对中国现实社会的不间断的调查、实践和反思中形成的。这种思想转向是一种"社会科学"的转向,而不是文化立场的转变。本文以四个部分来论述这种转向的发生。前两个部分讨论费孝通晚年谱写的"两篇文章",即小城镇和乡镇企业研究、民族和边区开发研究。在这两个领域的经验研究中,费孝通都遇到了社会学和人类学上的挑战,他发现：乡村工业、民族和边区的发展都不只是经济社会政策的问题,甚至也不是经济和社会结构的问题,而是和其背后"只能意会、不能言传"的心态和文化有关。如何把握这些心态和文化,是本文的第三个部分,即费孝通晚年社会学方法论的主要内容。费先生从英国人类学家Leach因《江村经济》所提出的两个方法论问题入手,在生命的最后十多年里展开了漫长而严谨的反思。反思的结果一方面是对社会学研究方法论的新看法,也是对上述两个经验问题的总回答,另一方面是对"文化自觉"理论的方法论补充。本文的最后一个部分讨论的是费孝通作为一个社会科学家,晚年如何身体力行,在"差序格局"中"推己及人",延续了中国传统文化中以天下为己任的士大夫精神,是为真正的"文化自觉"。     

Spiritual Histories and Native Americans: A Mixed Method Validation Study

ABSTRACT

Although spirituality plays a central role in health and wellness for many Native Americans, surprisingly few spiritual assessment tools have been validated with this population. This mixed-method study modifies an existing spiritual assessment tool—spiritual histories—that may be particularly congruent with Native American culture. Using a sample of recognized experts in Native culture (N = 50), the study identifies: (a) the degree of cultural consistency, strengths, and limitations of the tool, conceptually, and (b) a culturally valid question protocol to operationalize the concept for use with Native clients. The findings are discussed in light of recent accrediting requirements mandating the administration of spiritual assessments in numerous settings and suggestions are provided to administer the assessment in a culturally competent manner.     

Adaptation and Evaluation of a Group Curriculum for Latino Clients in a Driving Under the Influence Program

The purpose of this study was to describe the process of culturally adapting group curriculum modules for Spanish speaking clients in a Driving Under the Influence Program as well as to test the acceptability of these modules. Using the Group Topics Evaluation Scale (English and Spanish version), 90 clients rated six modules that were presented in 30 different group sessions. Spanish speaking clients were significantly more likely to rate all six modules much higher than their English speaking counterparts, indicating acceptability. This is important as driving-under-the-influence programs may provide access to Latino clients not seen elsewhere. Possible further research is discussed.     

性别文化差异给跨性别文化交际带来的矛盾与困惑

男性和女性在语言运用过程中存在着语音语调、词汇、语法结构等方面的差异。性别语言差异源于男性和女性不同的心理特征、性别角色、社会分工、社会偏见、以及权势和支配欲。性别差异不只是生物学上的差异,而主要是一种文化构建。不同的性别角色促使男性和女性获得各自的角色行为,成为不同性别文化的成员。性别文化差异势必导致男性和女性在交际规则、交际风格、交际方略、心理定势、价值观等方面的差异,为两性之间的交际带来困难。只有了解不同性别的交际规则和交际方略,培养对容易导致交际失败的交际规则的敏感性以及性别文化差异意识,才能克服性别文化差异所导致的交际失败,达到有效交际的目的。     

Client-oriented Quality Assessment within Municipal Social Services

The hypothesis of this article is that quality assessment, despite the fact that it has now become a part of social services, has largely occurred without taking clients into consideration. There are supposed to be at least three possible explanations for this: organizational structures and professionalism, the difficulty in defining client needs, and the opinion that a client is not an equal companion in social service organizations. The research method entailed a questionnaire which was sent to 60 managers working within municipal social administration during the periods of construction (1950–1965), supplementation (1966–1983) and reform and redistribution (1984 onwards) of the Finnish welfare state and a questionnaire for 146 public social welfare organizations in Finland. Fewer than 30% of the social managers of the construction (1950–1965) and supplementation (1966–1983) periods and fewer than 50% of the managers of the last period (1984 onwards) said that clients really had assessed quality. The needs of clients and client feedback were said to be important during all three periods but the managers did not include them in the most important tasks. The managers of the period of supplementation did this the least. The managers from the period of reform and redistribution (1984 onwards) were more likely to trust the ability of clients to assess quality of social services and they also gave more opportunities to do so. The most important reasons for neglecting client needs and feedback in quality assessment were organizational structures and difficulties in defining client needs. There also seem to have been some methodological difficulties in assessing social services. Statistics are still largely in use and concrete criteria related to quality are missing. More specific questionnaires, cross-experimental designs and interviews, more possibilities for clients to describe needs in their own words, and the specification of general concepts in more concrete terms of quality are needed in order to avoid abstract and general assessments.     

‘I am the face of success’: peer mentors in child welfare

Child welfare systems have struggled to create innovative, culturally sensitive programmes to address the multiple and pervasive barriers that exist in engaging child welfare parent clients in their service plans. Peer mentor programmes—those in which parents who have successfully navigated the child welfare system and reunified with their children, mentor parents newly entering the system—are designed to address some of these barriers, to improve reunification outcomes. Focus groups with parent clients (n = 25) and interviews with peer mentors (n = 6) were conducted to identify the characteristics of peer mentoring programmes that are critically helpful to parent clients, as well as the mechanisms that allow peer mentors to be effective in their work. The qualitative analysis uncovered three general themes to which both parents and peer mentors frequently referred in interviews—the value of shared experiences, communication and support. Additionally, the study found that peer mentorship has positive effects not only on parent clients but also on the mentors themselves. The inclusion of peer mentors in child welfare practice suggests an important paradigm shift within child welfare that could lead to culture change for the field.     

The Social Work Assessment Tool (SWAT)

This paper reports on the last of three National Hospice and Palliative Care Organization initiatives to move hospice and palliative care social workers into the patient/family outcomes arena: the development of the Social Work Assessment Tool. The experience of a team of practitioners and researchers is described, including results of two pilot studies and subsequent SWAT revisions. The major focus is on the current model performance improvement project, in which 19 social workers from 14 hospice and palliative care programs used the SWAT with 101 patients and 81 primary caregivers for a median of 44 days. Quantitative analysis indicated significant improvement in SWAT scores for patients from the first to the second social work visit (t = -2.60, df = 47, p .01). Qualitative interviewing of the social workers indicated some lack of readiness in the field to conduct quantitative outcomes measurement. Additional measures are needed in addition to the SWAT, including qualitative measures, and measures of mezzo and macro practice. Participants indicated that the SWAT was appropriate for use with economically and culturally diverse clients.     

Kids' Club Letters: Narrative Tools for Stimulating Process and Dialogue in Therapy Groups for Children and Adolescents by DeGangi,G. A., & Nemiroff,M. A.

The benefits of assertion training have been well documented, but this approach to helping people become more effective in obtaining their rights has largely been confined to work with the middle class. In this presentation of a six-session workshop, the principles and techniques of assertion training are applied to the particular needs of public welfare clients. Specific exercises involving the use of behavior rehearsal, coaching or prompting, model presentation, and homework have been designed for use in training clients in assertion skills. This application of assertion training has been developed with a workshop format, but the exercises can be used selectively and integrated with other treatment approaches.     

Specialism, Genericism and Others: Does it Make a Difference? A Study of Social Work Services to Elderly People

Correspondence should be addressed to Roger Fuller, Social Work Research Centre, University of Stirling, Stirling, FK9 4LA Summary A previous paper published in this journal (Fuller and Petch,1991) described a preliminary feasibility study designed toinvestigate the effects of organizing social work teams alongspecialist or generic lines. The main study which developedfrom this work is here reported. The study, using modified casereview forms, compares the way samples of referrals of elderlypeople (n=1232) were dealt with at initial assessment and forup to a year subsequently by 15 social work teams of contrastingorganizational approach. The latter include specialist and genericteams, and comparisons are also drawn with teams adopting aself-styled community social work approach. Although the organizationalagenda has moved on since the study began, the issues are ofcontinuing relevance for the implementation of community care,particularly in view of its growing focus on specialist services.While not arguing that there is any one optimal model of teamorganization, the paper sets out some of the measurable consequencesof opting for the various models; in particular, it emergesthat the strengths of specialization are more clearly apparentin certain aspects of their engage ment with clients than inothers and at certain stages of that engagement than at others.     

Bystanders' Reactions to Bullying: A Cross‐cultural Analysis of Personal Correlates Among Italian and Singaporean Students

This study examined the role of attitudes against bullying and perceived peer pressure for intervention in explaining defending the victim and passive bystanding behavior in bullying. Participants were 1031 school‐age children from two culturally diverse settings, namely Italy and Singapore, which are similar on several dimensions (e.g., quality of life, child welfare) but dramatically differ on other aspects, such as individualism—collectivism orientation. Multilevel analyses showed that country and participants' gender moderated the relations between individual predictors and behavior during bullying episodes. In particular, although individual attitudes were a stronger predictor of Italian students'—especially girls'—behavior, perceived peer expectations were more strongly associated with behavior of Singaporean participants. This study contributes to the literature by being the first to provide data analyzing the association between defending and passive bystanding behavior and different correlates using a cross‐cultural approach.