Case Studies
Overview
There is an ongoing discussion in social work about the difference between cultural competence and cultural humility. In the documentary "Cultural Humility: People, Principles and Practices," several practitioners share their experiences with these terms from both personal and professional perspectives. The documentary argues cultural competency is a process that incorporates lifelong learning and self-reflection, mitigates power imbalances, and requires institutional accountability. Cultural competence "implies, especially for people who are providers and are trained in Academia, that you are all knowing and all powerful.” It frames things as “a sense of achievement and accomplishment.... Competence . . sort of limits you're learning.”
Whereas cultural humility is described as "a . . . process and a relationship that [has] many other layers to it...." Cultural humility requires a paradigm shift to “be really happy about not knowing...” Cultural humility is a “practice” that calls on us “to be open to learning all the time.” It also means "to really believe that the communities that are being served really do know what they want and what they need and they're in the best position to let us know what that is”
One of the practitioners describes the impetus behind the paradigm shift: " Families were comingto the hospital and feeling as if they really were not being heard from their own heritage or history," which impacted their care. She began to realize "that we didn't have a clue.“ This process requires self-reflection. As one interviewee describes,“[I learned cultural humility as a concept early in my life] It came from a place of invisibility. A place of . . .suppressing who I was as a woman of color and now [it] has completely transformed as an educator. Realizing who I am. Where I stand in the classroom. What my privilege is but also what my voice means in in the world and what it means as an educator... It came from trying to . . .fit in. To do whatever I could to be Indian at home and not out in the world - - not express that...It's become this . . .marker of identity that I knew was always there. That I could never really express growing up. Now it's saying who that person is and acknowledging both my own power and privilege. I [have] got to check myself. It's saying I am a woman of color. I have something important to say and here I am. I think as long as power and privilege exists in society we will always be struggling with being too humble as women of color, as women who come from women of color, as women who come from working class backgrounds, as women who come from low low-income backgrounds or under resource backgrounds. As long as there's power and privilege in society, I know I will always be struggling with that and I struggle with that on a daily basis”
Sometimes, this shift can be difficult. “There are things that are difficult to hear and there are things that are just plain hard to see. So, you know how it is a fish doesn't see water? It's very hard when you benefit from great privilege to see it as that. . . . It takes constant reminding.... I certainly don't see it all the time... Each time I'm reminded, I am reminded that I am reminded of it....” Another acknowledges, “for a long time, I mistook not knowing for lack of intelligence. [Until] a dear friend . . . pointed out, ‘it's not that you're not intelligent. [It] is that ....your fund of knowledge in this particular area ...[is missing]. .....It doesn't take away from your intelligence by any stretch of the imagination. You just don't know because no one's told you or you haven't asked that question. It allowed me to be able to ask a million questions now. I didn't feel like I was saying to the world or to the person or to the patient or to the community I'm stupid. I was actually saying. I just don't know.”
Prompt
Watch the video on cultural humility
Review the case studies described in the following pages: Mary, Jin, Renee, and Andrew. Pick a case study in which the client has at least one identity that is different from one of yours. For example, if you identify as a White female, you could select Jin, a Chinese-American male.
- Think about your intersecting identities and how your positionality influences how you will be perceived by your client. How might your different positionalities impact power dynamics in the client-clinician relationship?
Answer the prompts that follow the case study