Mental Health and Recovery Board Building Bridges to Recovery: Embracing Local Cultures LaVina Miller Weaver, RN, PCC-S Objectives 1. Identify cultural competence as a tool for decreasing stigma related to mental decreasing stigma related to mental illness and substance abuse illness and substance abuse 2. Develop an understanding of how local culture impacts communication, services culture impacts communication, services access, and service delivery access, and service delivery Trans-cultural Competency From Trans-cultural Counseling by John McFadden Five stages of Trans-cultural competence The ability to discover anothers way of knowing. Stage I Ethnoentropy Ethnoentropy We are alienated from our own cultural identity understand little of self or own culture understand little of self or own culture Stage I contd Avoid other ethnic groups and cultures when possible, great discomfort, not yet able to move toward great discomfort, not yet able to move toward Alienated from self/other live out our rejected cultural identity live out our rejected cultural identity Unable to accept own cultural identity Unable to accept own cultural identity Stage II Ethnocentrism Ethnocentrism We believe in the inherent superiority of our own culture We see other cultures as inferior or wrong or wrong Stage III Ethnosyncretism Ethnosyncretism We begin awareness and acceptance of our own cultural base Dualistic thinking starts being challenged..we/they Dualistic thinking starts being challenged..we/they What we used to think no longer fits/works What we used to think no longer fits/works Faith crisis image of God changes Faith crisis image of God changes Stage III contd We begin accepting outside perspectives and critiques on our own culture without defending Greater capacity to contain differences Greater capacity to contain differences Less need to correct Less need to correct No longer need to see things right or wrong No longer need to see things right or wrong but as different or not yet understood but as different or not yet understood Capacity to listen increases Capacity to listen increases Stage III contd We begin accepting new ideas and practices from other cultures as well May begin exploring new practices/actions May begin exploring new practices/actions Moving from thought to experimenting Moving from thought to experimenting without sacrificing or rejecting our own cultural identity without sacrificing or rejecting our own cultural identity Early formation of transcultural core Early formation of transcultural core Stage IV Transethnicity Transethnicity We move beyond, or across, our own ethnic group to significantly experience another ethnic group or person Have an encounter/experience that shifts the core Have an encounter/experience that shifts the core New way of thinking becomes more comfortable New way of thinking becomes more comfortable Relationships may change Relationships may change Stage V Panethnicity Panethnicity We have developed a transcendent world view Anchored and flexible in new understandings Anchored and flexible in new understandings Willing to dialogue, find common ground, explore Willing to dialogue, find common ground, explore Hold ourselves and our world more lightly Hold ourselves and our world more lightly We view ourselves as members of ethnic groups of the world We are only a part of a whole instead of the whole We are only a part of a whole instead of the whole Can adopt from beyond earlier constraints Can adopt from beyond earlier constraints Stage V contd Stage V contd There is a sense of sharing a common global culture as well as my own unique culture as well as my own unique culture We are now free to choose We are now free to choose Integrating from our own heritage is now a choice Integrating from our own heritage is now a choice Characteristics of Trans-Cultural Competence Belief that all persons are worthy Regardless how feeble, how strong, how impaired Regardless how feeble, how strong, how impaired Understands people as unique individuals Value discovery of others Value discovery of others Is learning from others while also giving to others great sense of mutuality and sharedness Characteristics of Trans-Cultural Competence Believe in the capacity of all people to develop their highest potential Less of a need to compare Less of a need to compare Great capacity to inspire others toward their best Great capacity to inspire others toward their best See ethnicity as an opportunity for personal growth and understanding Great capacity learn and internalize experiences Great capacity learn and internalize experiences Can allow themselves to be changedongoingly Can allow themselves to be changedongoingly Why Cultural Competence? 1. We will be far less likely to stigmatize, to disregard, to set others apart if we allow ourselves to grow toward cultural competence if we allow ourselves to grow toward cultural competence Why Cultural Competence 2. Lack of cultural understanding can cause us to unintentionally violate and hurt our clients 2. Lack of cultural understanding can cause us to unintentionally violate and hurt our clients 3. It can keep people from seeking the help they may desire because they feel unsafe Why Cultural Competence 4. We will be more likely to speak up when we hear people being disregarded, we hear people being disregarded, sidelined, or stigmatized sidelined, or stigmatized Our Community 96.52% = White 96.52% = White 1.57% = Black 1.57% = Black 0.16% = Native American 0.16% = Native American.66% = Asian.66% = Asian.75% = Hispanic/Latin.75% = Hispanic/Latin 40%..speak German or Penn Dutch 40%..speak German or Penn Dutch (Holmes and Wayne County) (Holmes and Wayne County) The Heart of The Heart of Amishness Amishness Donald B Kraybill, The Riddle of Amish Culture On the Back Road to Heaven On the Back Road to Heaven G e l l a s e n h e i t A paradigm that under girds all of Amish Life A paradigm that under girds all of Amish Life Has ideas of Letting go, Surrender, Yielding Gelassenheit Gelassenheit orders the entire social structureit forbids the use of force in human relationships Gelassenheit orders the entire social structureit forbids the use of force in human relationships Dimensions of Gelassenheit from The Riddle of Amish Culture by Donald B. Kraybill Gelassenheit/Modernity Moderns value personal fulfillment and individual achievement Moderns value personal fulfillment and individual achievement The way of Gelassenheit discovers fulfillment in communityand receives in return a durable and visible ethnic identity The way of Gelassenheit discovers fulfillment in communityand receives in return a durable and visible ethnic identity Gelassenheit/Modernity Amish work just as hard at losing themselves as moderns work at finding themselves Amish work just as hard at losing themselves as moderns work at finding themselves There is an ordered sense of doing things right and wellGod watches all we do There is an ordered sense of doing things right and wellGod watches all we do if it is worth doing, it is worth doing it if it is worth doing, it is worth doing it right right The Shrinking Edges of Gelassenheit Toward individualism Toward individualism Public recognition signing name Public recognition signing name Business Cards Business Cards The Shrinking Edges of Gelassenheit However, Obedience, humility, plainness, and simplicity remain powerful engines of resistance to dominant culture Obedience, humility, plainness, and simplicity remain powerful engines of resistance to dominant culture The Amish, Don Krabill The Amish, Don Krabill "Upside-Down Values" "Upside-Down Values" The individual is not the supreme The individual is not the supreme reality reality Communal goals transcend personal Communal goals transcend personal ones ones "Upside-Down Values" "Upside-Down Values" The past is as important as the The past is as important as the future (persecution history) future (persecution history) Tradition is valued equally with Tradition is valued equally with change change Upside Down Values Personal sacrifice is esteemed (and Personal sacrifice is esteemed (and rewarded) over pleasure: rewarded) over pleasure:. Local involvement outweighs national Local involvement outweighs national acclaim acclaim "Upside-Down Values" "Upside-Down Values" Work is more satisfying than consumption: utilitarian culture Work is more satisfying than consumption: utilitarian culture Obeying, waiting, and yielding Obeying, waiting, and yielding are embraced are embraced Newer, bigger, and faster are Newer, bigger, and faster are not better: not better: "Upside-Down Values" "Upside-Down Values" Preservation eclipses progress Preservation eclipses progress Staying together is the supreme value Staying together is the supreme value Values Larger family and extensive church ties Larger family and extensive church ties Accustomed to caring for their own Accustomed to caring for their own Defer to leadership/authority Defer to leadership/authority Difficulty verbalizing if disagreeing with authority figure Difficulty verbalizing if disagreeing with authority figure Values Stoic with emotional and physical pain Stoic with emotional and physical pain Concrete, detail orientation Concrete, detail orientation Value face to face communication Value face to face communication Our Community What is the impact of this population on our community??? What is the impact of this population on our community??? How has the community been shaped by this people??? How has the community been shaped by this people??? How does understanding this community impact the delivery of mental health care??? How does understanding this community impact the delivery of mental health care??? Our Community Communication language barriers Communication language barriers Service deliverycultural competency Service deliverycultural competency Service accesstransportation issues Service accesstransportation issues Values conflictscultural competency Values conflictscultural competency Our Community Dealing with a significant sub-culture while at the same time providing services for a larger culture. Dealing with a significant sub-culture while at the same time providing services for a larger culture. Requires understanding of both the broader culture and the sub culture Requires understanding of both the broader culture and the sub culture (Interest in sub culture can trump the need for understanding of the larger culture) (Interest in sub culture can trump the need for understanding of the larger culture) Our Community The dynamics of our community with the Amish positions us uniquely for significant cultural training, and for contribution to the field of Transcultural Counseling. The dynamics of our community with the Amish positions us uniquely for significant cultural training, and for contribution to the field of Transcultural Counseling.