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Beyond Cultural Competence – Working Towards Culturally Appropriate Evaluation Methods

The importance of cultural considerations when conducting evaluations, particularly with respect to evaluations of mental health programs, has been generally accepted for some time. However, the often-used notion of “cultural competence” has some limitations.

The idea of “competence” implies traditional notions of “expertise,” but culture is not like traditional bodies of knowledge – culture is more fragmented and contradictory. Although every member of a particular culture may share certain experiences that shape how they make sense of the world, every individual will have additional personal experiences that may lead them to make sense of the world in contradictory ways compared to their peers. Some of this is attributable to the intersection of different identities (i.e., U.S. born trans Latinx students will have different experiences related to race/ethnicity than immigrant trans Latinx students), however, this still does not quite account for everything.

So, what do we do? First, instead of working to develop “expertise” in a particular cultural group or subgroup, or to rely on “experts,” a perspective of sensitivity to cultural influences and differences should be developed. Second, a commitment to prioritizing understanding of the client’s experience should be prioritized.

Sensitivity can be developed by spending time learning about the legal, political, and social history of a particular cultural group. In addition to current demographics about disparities, this information can be supplemented by e.g., researching relevant local/regional/national/global histories about how this particular group (and/or the corresponding geographic location) has been conceptualized in the law, by science, by religions, etc. This background can provide important contextual information that can increase insight into concrete evaluation questions, such as: Why is this group less likely to seek out care? Why is this group so difficult to collect feedback or data from?

Understanding can be prioritized by using active, empathic listening. What this means, then, is using your developed sensitivity to cultural context to more deeply appreciate what (and why) the client is saying what they are saying (or doing what they are doing). Prioritizing empathic listening also helps minimize the chance that some theoretical framework developed as a “competency” is not imposed over a client’s experience, thereby missing any further individual-level nuance that might otherwise have been understood. This can help further tailor the evaluation to the individual client’s needs and context.

Further Reading:
Carpenter-Song, E.A., Schwallie, M.N., & Longhofer, J. (2007). Cultural Competence Reexamined: Critique and Directions for the Future. Psychiatric Services, 58(10).

“If you can’t measure it, you can’t improve it.“

– Peter Drucker

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