Cultural Competency: Understanding Different Views of Disability in Order to Provide Better Service

by Stacey Kowbel

People of different races and cultures (particularly visible minorities) tend to be at an automatic disadvantage and experience many forms of stereotyping and negativity (e.g., Flynn, Chatman, & Spataro, 2001). How then, does being a minority who has a disability influence the quality and type of vocational and rehabilitation services received?

Past research has shown that minorities tend to be accepted into vocational rehabilitation services less often (e.g., Feist-Price, 1995); that they tend to earn less than their majority counterparts when they obtain a job (e.g., Wilson, 1999); and that in general they are less likely to be in the system (e.g., Atkins & Wright, 1980).

Atkins and Wright (1980) pointed out that minorities were less likely to be in rehabilitation services in general. In separate studies, it was shown that Japanese Americans (Atkinson & Matsushita, 1991) and Mexican Americans (López, López, & Fong, 1991) preferred to have counsellors of the same ethnic background as themselves. Therefore, if counsellors who are from the same ethnic background are not available, these individuals may not seek service or may be dissatisfied with the services they are receiving.

Another factor that may be involved is the beliefs behind programs/ treatments. The beliefs most often incorporated into these programs are Western ones, involving concepts of independence, self-reliance, emotional detachment, belief of personal control over events surrounding oneself, and competitiveness (Barrio, 2000). Unfortunately, these beliefs and values are different from those of collectivist cultures that tend to emphasize interdependence. The individualist views held in services may not meet the needs of collectivist cultures and these individuals may not seek these services in the first place, or may decline further participation once help has been sought and it becomes clear that their collectivist cultural needs are being ignored or will be ignored.

Challenges and Barriers Faced by Minorities Entering into Service Programs

With the rising number of immigrants who come from different parts of the world and speak different languages, many challenges can face them when they use services provided. In China, for example, a preference for family and community support over institutional care tends to be prominent. Because of the Chinese government’s one child per couple policy, however, more official attention has been given to the mental health of children, and special education is on the rise. Liu (2001) explains that, in China, children with developmental disabilities attend schools for children with developmental disabilities, unlike Canadian or U.S. systems. One of the reasons for this seclusion is the parents’ belief that their children would not receive the specialized attention needed in mainstream schools. Thus, individuals who have immigrated to the U.S. from China might not seek help because of their differing educational beliefs.

Immigrants from other parts of the world who do not speak ?uent English tend to claim that the largest problem experienced with service providers is the language barrier (Sung, 1985). While language itself causes a main barrier
in communication, style of communication could also be a problem. For example, North Americans tend to communicate directly and explicitly, relying less on nonverbal communication, while Chinese communicate more indirectly and less explicitly, with a heavy reliance on nonverbal communication (Liu, 2001). With such a heavy reliance on nonverbal
communication, much is left open to interpretation and there is a much greater chance of miscommunication. In addition, the manner of the Chinese is to be non-confrontational. This particular communication barrier may lead to dissatisfaction in services, and rather than confront the service professionals with their opinion, a discontinuation of service may occur.

The level of family involvement also differs across cultures. The Chinese, for example, have a high respect for their elders (Liu, 2001). Therefore, involving family members in the decisions that are made is an important step to ensuring more holistic services. Ignoring the opinions of various family members could be considered disrespectful and lead to the clients dismissing services that may be needed to achieve a desired lifestyle. In the Jamaican culture, family opinion is also important (Miller, 2002). Family, however, is extended beyond the immediate family to close friends. Close friends will even take a child to the doctor or other scheduled appointments and act as the parent in these situations. To question this relationship can cause offence and create barriers between the service professionals and the family.

Different cultures view disability and its origins differently

In addition to communication barriers and differences, and differences in the level of family involvement, there are also some key differences in how different cultures view disability and the cause of disability. For example, people hold different beliefs about the role of fate, some view disability as a punishment, and others have positive views of disability (Hanson &
Lynch, 1990). Hanson and Lynch describe that in some cultures, family misgivings are responsible for disabilities. Some Asian, Pacific-American, and Anglo families hold the belief that the disability is some sort of punishment for sins (e.g., because of something the mother or father did during the pregnancy). This belief can lead to the disability being an
embarrassment to the family because it shows that some kind of indiscretion was committed by a family member. In some cultures, such as the Jamaican culture, families will hide the fact that an individual has a disability and ensure that people do not have any contact with these individuals (Miller, 2002).

In some cultures, however, disability can have a positive meaning. In the traditional Navajo tribe, a person with a disability is viewed as a teacher and there is a belief that these individuals possess some sort of sixth sense or unique gift (Rogers-Adkinson, Ochoa, & Delgado, 2003). Intervening with the disability is therefore believed to interfere with any messages that may be delivered to the tribe or interfere with the individual’s gift.

The importance of cultural competency

Based on the few differences noted above and some of the differing views of disability and the cause of disability, it is clear that service organizations need to be culturally competent in order to serve the general population, rather than just the majority population. By considering a person’s culture, the organization would be able to provide services that meet the needs of each individual, reducing the risk of unsuccessful or client-terminated cases.

Key Points

• Minorities are less likely to be in rehabilitation services.
• When minorities do seek services, they tend to regard it as important to have counsellors who are culturally similar to themselves
• Support of cultural beliefs is important in providing more holistic services

Main Challenges and Barriers

• Language
• Communication style
• Educational beliefs
• Level of family involvement
• Cultural views of what it means to be disabled

References

Atkins, B. J., & Wright, G. N. (1980). Three views: Vocational rehabilitation of Blacks: The statement. Journal of Rehabilitation, 46(2), 42–46.

Atkinson, D. R., & Matsushita, Y. J. (1991). Japanese-American acculturation, counseling style, counselor ethnicity, and perceived counselor credibility. Journal of Counseling Psychology, 4, 473–478.

Barrio, C. (2000). The cultural relevance of community support programs. Psychiatric Services, 51, 879-884.Feist-Price, S. (1995). African Americans with disabilities and equity in vocational rehabilitation services: One state’s review. Rehabilitation Counseling Bulletin, 39, 119–129.

Flynn, F., Chatman, J. A., & Spataro, S. E. (2001). Getting to know you: The influence of personality on the alignment of self-other evaluations of demographically different people. Administrative Science Quarterly, 46(3), 414–442.

Hanson, M. J., & Lynch, E. W. (1990). Honoring the cultural diversity of families when gathering data. Topics in Early Childhood Special Education, 10, 112–131.

Liu, G. Z. (2001). Chinese culture and disability: Information for U.S. service providers (CIRRIE Monograph Series). Buffalo, NY: Center for International Rehabilitation Research Information and Exchange.

López, S. R., López, A. A., & Fong, K. T. (1991). Mexican Americans’ initial preferences for counsellors: The role of ethnic factors. Journal of Counseling Psychology, 38, 487–496.

Miller, D. (2001). An introduction to Jamaican culture for rehabilitation services providers (CIRRIE Monograph Series). Buffalo, NY: Center for International Rehabilitation Research Information and Exchange.

Rogers-Atkinson, D. L., Ochoa, T. A., & Delgado, B. (2003). Developing cross-cultural competence: Serving families of children with significant developmental needs. Focus on Autism and Other Developmental Disabilities, 18, 4–8.

Sung, B. L. (1985). Bicultural conflicts in Chinese immigrant children. Journal of Comparative Family Studies, 16, 255–269.

Wilson, K. B. (1999). Differences in hourly wages and hours worked between successfully rehabilitated African Americans and European Americans: The more things change, the more they stay the same. Journal of American Rehabilitation, 30, 10–15.