It seems to me that within the behavioral health service field, cultural competence is an approach designed to improve access, engagement, retention, and to contextually improve the quality of life of individuals and families. Within a cultural competence framework, services facilitate collaboration with culturally diverse communities. Cultural competence counseling is based on an inclusive theoretical orientation, which creates an understanding of the person’s culture and worldview. Central to cultural competence is the socio-cultural context and its relationship shaping problem definitions and the consideration of social and intra-psych variables. The collaboration of cultural competence and recovery principles is a natural union in the improvement and compliance with mental health and addiction services. Working in partnership, both interventions can support and learn from each another. For example, let’s consider characteristics of both concepts.
Both interventions give legitimacy to the client’s participation in her/his treatment and the socio-political process while at the same time challenging those social forces that affect a client’s life while receiving treatment. Harmonious with cultural competence, recovery is a continuum process for improvement and self-efficacy. Recovery is about healing the effects of an illness and its consequences (Spaniol, Gagne&Koehler, 2002). It is related to reclaiming and affirming the self. Recovery from mental illness and addiction includes both the skills to manage a health condition and to facilitate life in the community (Tondora & Davison, 2006). It is about restoring self-esteem while endorsing self- identity (Deegan, 1997).
Cultural competence and recovery approaches must be tailored to increase the quality and appropriateness of care. The person-environment interaction and a collaborative therapeutic relationship are significant to the integration of both culture and recovery. The person-environment construct reminds us that services need to be specific while validating different worldviews and reinforcing cultural identity (D.W. Sue, 1996).
Designing services that are in accordance to the client’s culture equates to sustainability of recovery. Recovery principles and cultural competence inclusion can be defined as a service philosophy and a set of congruent practices, guidelines, skills, quality of life improvement, and symptom management. Also, recovery principles and cultural competence inclusion is about supportive behaviors and attitudes that enable a system of care and individuals to work effectively for the benefit of its clients. Integration of both principles makes recovery meaningful and relevant while giving clients validity for knowing what they need. Therefore, cultural competence principles and recovery practice methods are inclusive and participatory.
Cultural competence informs recovery by its practical applications. For example, by understanding the cultural context in which behaviors are manifested and by knowing the cultural forces that influences people to seek help; organizations can develop recovery-oriented initiatives that enhance the treatment experience. In this way, recovery and culture are embedded in the development and implementation of congruent treatment practice.
Cultural competence and recovery treatment approaches must include interventions that respond to a client’s often culturally pre-determined needs. And the organization providing services must incorporate a genuine commitment in words as well as in actions by developing policies and practices consistent with the goals of recovery and cultural competence. These commitments must come from the top administration and from a clear mission statement and strong leadership initiatives. The development of policies needs to be translated into a recovery and culturally competent operational definition. The organization must allow for cultural competence and recovery progress monitoring. In addition, a recovery and cultural competence committee must be formed and charged with the capacity to influence and make decisions inclusive of both initiatives. These services and interventions will serve as a strong message to their staff and clients about the seriousness and importance of good and quality care. Furthermore, by incorporating cultural competence and recovery principles into performance appraisals the organization solidifies its mission and treatment philosophy.
The achievements of individual and organizational recovery and cultural competence goals are not accomplished by words alone. Careful planning is necessary. Organizations must perform a cultural competence and recovery service assessment, addressing their strengths and areas needing improvement, barriers and available resources for instituting changes. Planning for both initiatives must include development of cultural competence and recovery policies. Staff from all levels of the organization and consumers must be involved in designing policies that reflect the community and all those individuals that could be affected by changes. The organization’s administrative staff becomes responsible for policy implementation, while monitoring its daily effectiveness.
Cultural competence and recovery- oriented organizations will begin by developing training and supervision programs that focus not only on general multicultural knowledge, but also on the dynamics of difference within a socio-political system. Mental health and addiction professionals must be receptive to explore their belief system and potential stigma when working with individuals affected by behavioral disorders and the culturally different client. Clinicians must develop awareness, knowledge and the necessary skills to work effectively with multicultural populations.
Organizations need to develop policies and practices, as well as the structures that support and enhance cultural competence while including recovery principles in the provision of all its services. It’s acknowledged that both principles require considerable commitment and time devotion.
Cultural competence services must be understood and recognized contextually, and recovery must be integrated as a significant and valued component of the organizational structure of behavioral health care. Mental health and addiction professionals will benefit by embracing both concepts and by becoming familiar with the President’s New Freedom Report on Mental Health, the U.S. Department and Human Services report on Mental Health Culture, Race and Ethnicity, and the Institute of Medicine’s report on Health Disparities.
