When is Cultural Incompetence Okay?

Blind by *EmalaithOk…I need to rant a bit about a pet peeve.

<rant>I was at a gathering recently where some social work colleagues–therapists in this case–were talking about Facebook–several  proclaimed proudly that they aren’t on Facebook and that they don’t understand it at all. Then, in the next breath they acknowledged that many of their clients use Facebook a great deal.

I was left wondering how you can practice effectively with people if you don’t understand significant parts of their lives. Mind you, I’m not saying that all social workers need to be on Facebook (or whatever the platform). But doesn’t the principle of culturally competent practice require that we at least understand the important aspects of their worlds?  For example, if I don’t understand the platform, how can I help my client determine how to set boundaries in this new medium? Setting boundaries requires an understanding of what’s normative and what works in a particular setting.

Are there any other areas of people’s lives where we would find this level of therapist ignorance acceptable? I don’t think so. And yet I still repeatedly come across social workers, psychologists, psychiatrists and other human services professionals who proudly declare their ignorance of new media, social media, and much of the Internet. </end rant>

As with all areas of cultural competence, it’s not necessary to know everything about something ahead of time. But what is required is a sense of respect and curiosity, a willingness to learn. What distresses me most about the attitudes I encounter in some of my colleagues is their disdain and dismissiveness when discussing social media, social networking sites, and Web 2.0. Such attitudes can only create barriers in therapy when the client is someone who integrates new media into their lives. And over time, it might well lead to therapy become less relevant for a generation.

Photo Credits: *Emalaith

22 thoughts on “When is Cultural Incompetence Okay?

  1. I appreciate your thoughts on this. Not everyone may be comfortable with the social media networks etc. But I agree that it’s important to understand it as a cultural competency. I see the popularity of the social networking as an expression of the human need to connect, relate, etc. Although I’d prefer sitting with people in person over a cup of coffee, and see them “face to face,” and write or read an actual hand written letter or card, I’m glad that people apparently want to connect. The Sufi’s say there are 3 ways to honor what is holy. The first is prayer, the second and higher form is meditation. But, they say the highest form of honoring what is sacred, holy, (you fill in the blank), is “Conversation” with another person. I’m all for better conversations at all spheres of our world and personal lives.

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  2. Thanks so much for adding this Sufi wisdom. I love it! Connection/conversation truly is sacred. And I do think that is what is driving social networking. It also helps to understand why people who meet in these virtual spaces often seek to then meet people through “meet-ups.”

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  3. It’s a great point. Whether we like it or not, social media changes the way we communicate. It is especially true for Gen Y. Will human services professionals be able to connect with their GenY clients?

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    • I’ve wondered that, too, Anastasia…whether Gen Y clients will feel a sense of being understood if there are key aspects of their lives that their therapists don’t comprehend. Might make for an interesting research study.

      I’ve also wondered if social work–my particular profession–is going to be deemed irrelevant as a career choice by Gen Yers because we don’t have a strong Internet presence. It’s part of why I had our School start our social work podcast, hoping that it would help attract some people to the profession just because they stumbled across some of the topics that were of interest to them.

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  4. Hi Nancy, I think you’ve brought up a very important topic. The problem is that you’ve raised it here on the internet. i.e., it is unlikely to be read by those very same people who have an issue with familiarizing themselves with facebook, the internet, twitter etc.

    I’m wondering if there is some way of having this posted so that mental health professionals who are unlikely to have access to your blog would also be able to benefit from it…perhaps you’d like to share it with the NASW and/or the New Social Worker. Both organizations issue hard copies of their newsletters and/or magazines.

    What is so surprising to me isn’t the lack of knowledge or familiarity but rather the lack of receptivity to the new media that some of your colleagues have shown. I wonder if they are a bit afraid of the new technology. Sometimes the fear of the unknown in something new makes people shut down. If that is the case, you may be able to get your colleagues to open up by providing some sort of low key friendly “getting to know the internet” class for them so that they could gain a mini-introduction to the most popular social networks.

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  5. Excellent point, Dorlee, and one I actually have thought about, that it’s preaching to the choir, so to speak.

    I’m not sure about what the best formats might be to share it with the two sources you’ve mentioned: maybe a letter to the editor? It’s kind of short for an article. Any thoughts on that? It’s been a while since I’ve looked at either of those publications closely.

    I think fear is definitely an issue for many people in human services. But the other issue is arrogance–an anti-technology attitude–that I’ve seen before in people in human services. I think in this case it was more what was operating. The conversation almost had a flavor of superiority (“we’re not into such shallow, trivial things”).

    Doing a workshop is something I’ve been talking to our Continuing Education director about–and I do think we’ll be doing this at some point. But of course, that only works on a local level.

    It’s definitely something I’ve been thinking more about–what the right way to address this might be.

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  6. I don´t agree. I rather to believe that what is learned in a therapeutic relation and treatment frame can be generalized by the patient where he/she considers OK.
    Its their responsability. Its not that I don´t care; its I think its up to them where to carry this out. If advicing would part of my job during therapy, I would advice patients to try to improve real relations.
    Best,
    Olaf

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    • I agree completely that advice-giving is typically not appropriate in therapy. That’s not what I’m talking about. Therapists draw on a wide range of knowledge about human development and social relationships–that’s part of what goes into a therapeutic assessment. If a therapist is uninformed about norms and cultural context, his or her ability to knowledgeably conduct a psychosocial assessment is impaired. This, in turn, could affect the formulation of an intervention strategy.

      In addition, not all client populations readily generalize changes to other settings, and not all client populations are able to assess what’s appropriate and inappropriate in terms of boundaries. Again, in these situations the therapist needs to understand the cultural and human/social behavioral context, not for the purpose of advice-giving, but for the purpose of guiding the therapeutic process. Clients who have difficulty generalizing to some settings (for example, people diagnosed with dissociative dissociative disorders, personality disorders, chronic depression) may need help with through a guided therapeutic process to help them completely transfer what they know. In this situation, the therapist’s ability to guide the process will be limited if he or she isn’t at least knowledgeable enough about the context to do so intelligently. The best case scenario would require me, as the therapist, requiring that the client teach me all I need to know to guide him/her. While some of that might be fine, too much of it raises ethical questions about why the client is paying for the privilege of educating the therapist so s/he can ultimately help the client.

      If none of the above resonates with you, then my guess is that we might be working with very different client groups. In my practice, my clients who functioned at high levels were most likely to generalize spontaneously and on their own. Those clients who had more significant problems (serious addiction, repeated self-harm, frequent dissociative episodes, significant suicidality, living in an ongoing abusive environment) needed more therapeutic focus on helping them discover how to negotiate their social environments.

      Thanks for sharing your perspective on this–it focused the dialogue in a direction that wouldn’t have been explored if you hadn’t bothered to comment!

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  7. Nice post about the intersection of cultural competency and contemporary social media favored by emerging adults (or fully realized adults for that matter). My initial reaction was to bring curiosity to my client’s experiences–digital or otherwise. I am more interested in how they experience the use of social media and digital conversations/relationships than my own immersion. “Tell me more about…” or “What do you experience in your body while using [whichever app]?” How do they make meaning out their use of social media, internet, etc. What is their relational experience of…? I also want to pay attention to my implicit reactivity when they discuss social media or any other expression of culture that is less/un-known by me. What emotional sensations in my body, what auditory/visual thoughts have been activated by the discussion? And then, how do I relate to my own reactivity?

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  8. Curiosity is at the heart of all of this, Bob, I think you have nailed it. There are so many ways to come at it, but curiosity is key. Those are wonderful questions to ask–thanks for sharing them.

    As I started to write about this topic I remembered that it was my curiosity about what clients were doing that brought me to blogging (a client had her journal on a blog), and then again to Second Life (a client was spending some time there). Blogging was pretty easy to understand, but Second Life took a while for me to get my brain around.

    When I think back about the conversation I overheard, curiosity was a key part of what was missing.

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  9. Greetings!

    I am a graduate research assistant for Dr Emily Douglas at Bridgewater State University in Massachusetts. Dr. Douglas is conducting a new study on child maltreatment fatalities. She has studied, taught, and published regularly on this topic, which is also the focus of her year-long fellowship in 2010-2011. We are actively recruiting participants for this online, anonymous survey. I write to inquire if your organization would be willing to post a recruitment statement on your Blog site about the study. If interested in helping out, please email me at: smccarthy@student.bridgew.edu

    We thank you in advance for your consideration.

    Sincerely,

    Sean McCarthy, MSW Candidate

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  10. I think my comment is a little late to the convo here, but nonetheless I wanted to share.
    I liked your rant and I think we probably share some similar interests when it comes to social work and technology. I do think it is important to understand clients lives from where they are, Rogers did too 🙂 I also agree with your later comment that conversation/connecting is what is driving social networking. Now I also understand that therapists, social workers, etc. may not want to be friends with all their clients, I’m not promoting that at all. But I do think that having a basic understanding of the platform would help the therapeutic relationship. I think you basically stated this before so hopefully I’m not being overly redundant here, lol. I just think it is very interesting how there seems to be a negative stigma towards technology in social work. Is this something you have seen or experienced?

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  11. I love hearing from people on this topic (even if they don’t agree) at any time, so thanks for taking the time to comment.

    I have seen and experienced quite a bit of negative stigma toward technology in social work. In my experience, it generally takes two forms: 1) based in fear: fear of the impact of technology (technology is evil) or based in personal fear about feeling inept with technology; 2) trivializing technology or looking “down” on it. This perspective is more of a sense that technology really couldn’t contribute anything valuable to social work. My rant above was triggered more by encountering the latter attitude.

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