Cultural competence in child and adolescent behavioral health is just as essential as it is in mainstream adult services for effective care. According to the American Psychological Association (2021), while ethnic and racial minorities represent 40% of the U.S. population, they make up only about 16% of the psychology workforce. Families of immigrant origin or those from diverse ethnic backgrounds bring unique values, beliefs, and practices, all of which play a significant role in shaping how children engage with behavioral health services. However, cultural competence extends beyond conventional training programs. It must also be embedded in organizational hiring practices. Employing a diverse workforce, one that includes providers who not only speak the language but also share cultural backgrounds with the populations they serve, can significantly improve treatment outcomes (SAMHSA, 2021).
Language Barrier
For immigrant families, language isn’t just a tool for communication; it’s the key to understanding and being understood. Some children might speak fluent English, but their parents or guardians may not, making it difficult for families to fully engage in treatment. This creates a roadblock in the therapeutic process. When parents cannot fully communicate with the provider or when they have to rely on their child to translate, the therapeutic process suffers. It’s not just the clinical details that are lost in translation; important emotional cues and family dynamics might also go unnoticed. The child, already under stress, may feel the added burden of interpreting for their parents, compounding the emotional strain.
But there is hope. Many community health centers are now adopting strategies to bridge these gaps, such as hiring bilingual therapists or offering interpretation services. These simple steps can make a world of difference, not only in ensuring that families feel heard but also in helping them access the support they need.
Cultural Misunderstandings
Cultural norms also play a big role. Parenting styles that work in one culture may seem unfamiliar or even troubling, to a provider who is unaware of the cultural context. What one family considers an acceptable form of discipline could be labeled “abuse” by a provider without the cultural competence to interpret it correctly. In these cases, the gap between a child’s needs and the provider’s understanding widens, making treatment not only ineffective but also emotionally damaging. In addition to this, a provider might classify a behavior as “resistant” or “defiant” when, in reality, the child is simply following cultural norms that emphasize emotional restraint. Without understanding this cultural difference, a provider might miss the signs of distress, leading to misdiagnosis and further alienation from the very system meant to help.
A Cultural Shift in Behavioral Health
Imagine a scenario where a child walks into a provider’s office, but this time, the provider speaks their language, understands their cultural background, and approaches the session with openness and respect. The provider doesn’t just provide clinical care; they create a space where the family feels seen, heard, and respected. This is the power of cultural competence.
Cultural competence in child and adolescent behavioral health isn’t just about understanding the specific beliefs of different cultures; it’s about respecting the family’s role in the child’s well-being and understanding that parents from different cultural backgrounds may have different views on mental health, discipline, and child-rearing practices.
Without cultural competence, the healthcare system risks losing the trust of families who may already feel marginalized. This is especially true for immigrant families, who often come from countries where mental health treatment may carry a stigma or where the healthcare system is vastly different. For these families, building trust with the provider is essential for effective treatment.
Strategies for Enhancing Cultural Competence
- Providers should engage in ongoing cultural competence training to better understand the communities they serve.
- Behavioral health service agencies should mandate trainings and prioritize hiring professionals from diverse backgrounds or those who are bilingual to help bridge language gap.
- Parents or caregivers should be actively involved in treatment planning, and throughout the process.
- Providing family therapy sessions in culturally responsive manner, where possible, to ensure that everyone involved in the child’s life understands the treatment plan and feels heard.
- Offering materials, resources, and consent forms in multiple languages to ensure families fully understand their rights and treatment options.
- In places where the mental health workforce lacks diversity, intentional efforts should be made to match clients with providers who share similar cultural backgrounds or have experience working with their communities.
Oyindamola Williams, LMSW, is a Child and Family Therapist at Southwest Community Health Center. For more information, resources, please contact oyinwilliams01@gmail.com.
References
American Psychological Association. (2021). Demographics of the U.S. psychology workforce. www.apa.org/workforce/data-tools/demographics
Substance Abuse and Mental Health Services Administration (SAMHSA). (2021). Improving cultural competence in behavioral health care. U.S. Department of Health & Human Services. store.samhsa.gov/sites/default/files/d7/priv/sma14-4849.pdf
