Cultural Humility for Child Welfare Professionals: A Paradigm Shift

Training Child Welfare Workersfrom an Intersectional CulturalHumility Perspective: A Paradigm Shift

The increasing diversity of the populationsencountered and served by child welfareworkers challenges cultural competencemodels. Current concerns focus on the unin-tentional over-emphasis on shared groupcharacteristics, undervaluing unique differ-

ences of individuals served, and privileging worker expertiseabout the client’s culture, thereby exacerbating the powerimbalance between them. This article promotes cultural humil-ity in child welfare service delivery as a compliment to culturalcompetence, to liberate workers from expectations of culturalexpertise about others, and to actively engage the clients, inclu-sive of their cultural differences, in the service delivery process.Skills and practice principles are discussed.

Robert M. OrtegaUniversity of Michigan

Kathleen CoulbornFallerUniversity of Michigan

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Within the past decade, child welfare services have seen aplethora of cultural competence training models designed to

assure that cultural factors are taken into account when workersinteract with children and families receiving child welfare services.Numerous resources have become available both online and in printto assist professionals in developing culturally responsive practices.A recent search on the Child Welfare Information Gateway resultedin numerous training programs and modules nationwide coveringa wide range of child welfare challenges to assure culture is recog-nized as an important part of the service delivery process (www.childwelfare. gov/systemwide/cultural/staff.cfm). Training in culturalcompetence included content focused on the primary racial and eth-nic groups identified by the U.S. Census (African American, Latino,various Native American tribal communities, and Asian Americans),immigrant communities, and multicultural populations.

A cultural competence framework challenges workers to developpractice knowledge and skills for working across cultures and withrespect to cultural and linguistic differences. Essential elements ofcultural competence include valuing diversity, developing culturalself-awareness, appreciating the dynamics of cross-cultural interac-tions, being knowledgeable about within-group cultural differences,and demonstrating an ability to develop service delivery that is rele-vant and responsive to the diverse and complex needs of the individ-uals, families, social networks, and communities (Fong & Furuto,2001; Gallegos, Tindall, & Gallegos, 2008; Lee, 2010; Lum, 2004;Lynch & Hanson, 1998; Nash & Velazquez, 2003; U.S. Departmentof Health and Human Services [USDHHS], 2001).

Drawing on Guba and Lincoln’s (1998) seminal work on episte-mological perspectives undergirding social sciences, Williams’ (2006)epistemological perspectives of cultural competence highlight differ-ent paradigmatic tools on which culturally competent practice can be

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Acknowledgments: The UM-SSW Recruitment and Retention of Child Welfare Professionals Program wishesto acknowledge the contributions of the project team and Michigan Department of Human Services for theirvaluable feedback and support. This grant was supported by the U.S. Department of Human Services,Administration on Children, Youth, and Families, Discretionary Programs, Child Welfare Training Grant, Award#90CT0115.

based—postpositivism, constructivism, critical theory, and post-modernism. Among the critiques offered from Williams’ observationis the point that how people conceptualize culture matters for inter-vening to the extent that each epistemological perspective offers adifferent lens through which culture and practice with culturallydiverse populations becomes operationalized.

Critiques of cultural competence models illuminate the manychallenges to child welfare work. A cultural competence focus onracial and ethnic differences, for example, may convey misconceptionsthat racial and ethnic groups can be understood as a set of observableand predictable traits, thereby instilling a false sense of confidence inworkers about their knowledge of culturally different individuals orfamilies (Cohen, 2009; Dean, 2001; Furlong & Wight, 2011; Johnson& Munch, 2009; Lee, 2010; Tervalon & Murray-Garcia, 1998;Weaver, 1998; Williams, 2006; Yan, 2008; Yan & Wong, 2005). Themany meanings of culture in terms of their social constructions, adap-tiveness, intergenerational transmission, and variations across time,generations, and sociopolitical contexts reflect the illusiveness of theboundedness of culture. Cultural experiences are best explained as anaccumulation of social experiences that are maintained, accommo-dated or assimilated therefore culture ought to be viewed as havingboth stable and ever-changing aspects that may be revised as a con-sequence of interaction with others (Cohen, 2009; Dean, 2001; Fiske,2002; Furlong & Wight, 2011; Gallardo, Johnson, Parham, & Carter,2009; Johnson & Munch, 2009; Lee, 2010; Triandis, 2007; Weaver,1998; Williams, 2006; Yan, 2008; Yan & Wong, 2005).

Coupled with the growth of increasingly diverse communities,their accompanying child welfare (and other) service challenges, andthe high rates of child welfare worker turnover, these factors makeexpectations of cultural competence increasingly infeasible (Dean,2001; Fiske, 2002; Furlong & Wight, 2011; Johnson & Munch, 2009;Korbin, 2002; Lee, 2010; Yan, 2008; Yan & Wong, 2005).

Critical race theory argues that a cultural competence perspec-tive typically fails to acknowledge the socio-structural mechanismsand institutional processes that prescribe and proscribe social injus-tices as a consequence of cultural differences when compared to

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mainstream, dominant society (Abrams & Moio, 2009; Adams, Bell,& Griffin, 1997; Casey Family Programs, 2000; Finn & Jacobson,2003; Gopaul-McNicol, 1997; Green, 1999; Ivey & Collins, 2003;Korbin, 2002; Tervalon & Murray-Garcia, 1998; Yan, 2008). Sueet al.’s (Sue, Bucceri, Lin, Nadal, & Torino, 2009; Sue, Capodilupo,& Holder, 2008) concept of microaggressions appears relevant to theexperiences of diverse populations in terms of both negative socialexperiences and the negative consequences in their search for help.

Cultural competence training has been argued to not go farenough in holding workers accountable for the privileged and powerposition their role entails. The expectation of cultural literacy amongworkers exacerbates the power imbalance between worker and client(Bogo, Tsang, & Lee, 2011; Furlong & Wight, 2011; Hernandez &McDowell, 2010; Yan, 2008). In the literature, a power dimension isused to explain how authority and control can be used to influenceand affect worker decision-making and client choices. Power hasbeen used to explain bias, prejudice, discrimination, sexism, ageism,racism, and so on that result in the poorest of the poor and particu-larly single parents, young caregivers, persons with mental illness, andolder caregivers being denied or having limited access to resourcesand support (Finn & Jacobson, 2003; Hernandez & McDowell 2010;Roberts, 2002; Sengupta, 2006). Positions of privilege and powerguards workers from uncovering the inextricable link between race,power, privilege, and racialized oppression and the social action calledon to effect systemic (e.g., agency) change (Adams et al., 1997; CaseyFamily Programs, 2000; Caughy & Franzini, 2005; Center for anUrban Future, 1998; Coalition for Asian American Children andFamilies, 2001; Finn & Jacobson, 2003; Hernandez & McDowell,2010; Ivey & Collins, 2003; Lee, 2011; Roberts, 2002; Velazquezet al., 2003). Ethical considerations, rights to self-determination,and the appropriateness of workers acting on behalf of clients withculturally different experiences from the worker’s cultural upbring-ing also become issues for concern (Gallardo et al., 2009; NationalAssociation of Social Workers, 2007, 2008; Yan, 2008).

As these critiques suggest, a cultural competence perspective,while applauded, is insufficient if the goal is to fully appreciate the


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unique contribution each person, family, and community (inclusiveof their unique cultural experiences) brings to the helping process.Ironically, the concept of cultural competence originated to pro-mote respect for cultural differences, yet may emphasize similari-ties at the expense of individual differences ( Johnson & Munch,2009; Korbin, 2002; McPhatter, 1997; Velazquez, McPhatter, &Yang, 2003; Yan, 2008).

Moving Toward Cultural HumilityCultural humility training offers another perspective for child wel-fare workers to use to work effectively with families that are cultur-ally different from them (Tervalon & Murray-Garcia, 1998). Thisarticle emphasizes important concepts such as multiculturalism, inter-sectionality, and cultural humility as important threads that weavetogether a critical aspect of child welfare work—engaging familiesas active participants in maintaining a safe and permanent livingenvironment that promotes child well-being (Korbin, 2002; Kossak,2005; McPhatter, 1997; Sengupta, 2006; Velazquez, McPhatter, &Yang, 2003).

A multicultural perspective moves us away from viewing cultureas monolithic. While the child welfare literature points out that“race” matters, and much controversy relates to the impact of raceon child welfare service delivery, race is but one social identity(Center for an Urban Future, 1998; Elliot & Urquiza, 2006; Fluke,Yuan, Henderson, & Curtis, 2003; Futa, Hsu, & Hansen, 2001;Harris & Courtney, 2003; Hernandez & McDowell, 2010; Hill,2006; Korbin & Spilsbury, 1999; Roberts, 2002). Multiculturalism,then, includes but is not limited to knowledge, beliefs, values, moralsand customs, language, behaviors, and practices of a single cul-ture but more accurately reflects our experiences with more thanone culture.

An intersectionality perspective asserts that people simultaneouslyoccupy multiple positions (positionalities) within the socio-cultural-political and structural fabric of society (Crenshaw, 1995; Harris &Courtney, 2003; Hill Collins, 2000; Hernandez & McDowell, 2010).


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These positionalities intersect and result in different behavior, depend-ing on the social context. For example, people occupy social posi-tions and may respond differently depending on gender, religiousbeliefs, race and ethnicity, socioeconomic class, age, ability, genderidentity, or sexual orientation. In child welfare, it is argued that inter-secting group memberships affect people’s expectations, quality oflife, capacities as individuals and parents, and life chances.

A cultural humility approach advocates for incorporating multi-cultural and intersectional understanding and analyses to improvepractice, since together these concepts draw attention to the diver-sity of the whole person, to power differences in relationships (espe-cially between workers and families), to different past and present lifeexperiences including microaggressions, and to potential resources orgaps (Brown, 2009; Furlong & Wight, 2011; Gallegos et al., 2008;Kossak, 2005; Lee, 2010).

A cultural humility perspective draws on three dimensions essen-tial to connectedness with one’s self and others (Morris, Brotheridge,& Urbanski, 2005). First, cultural humility promotes self-awarenessto the extent that people must appreciate who they are from a cul-tural perspective and how this shapes the lens through which theyview the world. Narayan (1999) draws on the concept of “epistemicprivilege” to bring attention to the fact that each person has animmediate, internally processed, and critical sense of who he or sheis relative to experiences. People, in a sense, walk the mile in theirown shoes and therefore are privileged to know themselves far morethan can be expected of others. By engaging in a process of realistic,ongoing self-appraisal of biases and stereotypes, workers are encour-aged to assess the ways in which their own attitudes and behaviorsprevent them from learning from their clients. Drawing solely ontheir own knowledge will not sustain new insights, awareness, andrelevant behavioral change. Engaging in a process of self-awarenessand self-reflection will ideally awaken the worker to the powerimbalance of workers and clients that may influence their responseto the services they provide.

A second dimension focuses on the characteristic of openness.Openness implies an appreciation of the fact that people do not and


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cannot expect to know all there is to be known especially about theworld, including the individuals with whom they interact. They mustacknowledge the world that functions outside of awareness that mayinfluence them in certain ways, consciously or unconsciously. Culturalhumility in this regard is an acknowledgment that the experiences ofothers, outside of themselves, require them to be open to their expe-riences, from their perspective. In human services, it is an essentialhelping virtue to the extent that it requires them to learn from thepeople with whom they aim to help.

The third dimension relates to Morris et al. (2005) concept oftranscendence. They write,

Transcendence can best be thought of as an acceptance ofsomething greater than the self. Out of this acceptance comesan understanding of the small role that one plays in a vast uni-verse, an appreciation of others, and a recognition that othershave a positive worth. (p. 1331)

A cultural humility perspective in the context of transcendence moti-vates people to consider the fact that in efforts to know themselvespersonally and professionally, as well as others in the helping context,people must embrace the reality that the world is far more complexand dynamic then perhaps they can imagine. People lend their expert-ise on the basis of what they know, and in the connections they makeas part of their helping. In child welfare, the worker must draw onthe cultural expertise of the families with whom they work and eventhen must recognize that the vastness of cultural experience likelyexceeds their capacities to fully understand all that is to be known.

In sum, a cultural humility perspective encourages workers totake into account an individual’s multiple identities and the ways inwhich their social experiences impact their worldview, particularlyas it relates to their expression of their culture. Demonstrating cul-tural humility frees workers from having to possess expert knowl-edge about an array of cultural differences. This perspective has thebenefit of placing the worker in a learning mode as opposed tomaintaining power, control, and authority in the working relation-ship, especially over cultural experiences about which the client isfar more knowledgeable. Freeing child welfare workers from the


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expectation that they must possess knowledge about their clients’cultural experiences is consistent with an important component ofwhat the social justice literature refers to as “liberation of con-sciousness” (Ivey & Collins, 2003, p. 293). Workers become liber-ated from the constraints of cultural stereotypes and boundariedknowledge about specific cultures and are encouraged to learn fromthe families they serve about their experiences, both past and pres-ent, from the “others” perceptions of their experiences, and themeanings they apply to their experiences. Furlong and Wight (2011)argue for renaming cultural competence to “critical awareness” tomove toward respecting an individual’s unique cultural experiencesand internalized cultural meanings.

A cultural humility perspective encourages a less deterministic,less authoritative approach to understanding cultural differences,placing more value on the child and family’s own cultural expressionsas they relate to their situation (Tervalon & Murray-Garcia, 1998).The worker relinquishes the role of expert to the client and insteadbecomes a learner who supports the client’s role of being a capable,contributing partner to the service delivery alliance. Cultural humil-ity is a child- and family-focused approach to service, beginning withthe initial report and investigation. Child welfare workers must neverlose sight of their responsibilities for child safety, permanency, andwell-being (Adams et al., 1997; Ivey & Collins, 2003; McPhatter,1997; Velazquez et al., 2003; Weaver, 1998), but they also should workin a non-paternalistic and respectful way with families.

Much of what a cultural humility perspective offers is consistentwith traditional social work practice (Anderson & Goolishian, 1992;Furlong & Wight, 2011; Hepworth, Rooney, Rooney, Stom-Gottfried, & Larsen, 2010; Kossak, 2005; Lee, 2010; Ross-Sheriff,2008; Yan & Wong, 2005). Starting where the client is, learning fromthe families, and demonstrating empathy are all important aspects ofcultural humility practice, but not sufficient. Cultural humility pro-motes practice skills and techniques that support culturally appro-priate interaction designed to reduce the worker’s need to master thewide range of different cultures and enable clients to describe theirview of problems. Cultural humility moves people deeper into an


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honest appraisal of cultural knowledge and awareness and diminishesthe illusion that professional expertise includes expertise of the cul-tural knowledge and experiences of the client that help to define them(and their actions) in the present.

A cultural humility perspective must also be considered an ongo-ing process rather than outcome (Tervalon & Murray-Garcia, 1998).It involves a worker’s commitment and active engagement in theprocess of mutual understanding and awareness of self in relation-ship to others. Workers must become continuously sensitized to fac-tors at play in defining important priorities and activities needed toachieve personal and family well-being. Child welfare workers arechallenged to identify, understand, and build on assets and adaptivestrengths of children and parents and perhaps engage in efforts tochange the kind of social forces that act to disempower them as mem-bers of society.

Cultural humility should include an assessment of the organiza-tional environment, policies, procedures, knowledge, and skills con-nected to worker practices (Child Welfare League of America, 2002;Tervalon & Murray-Garcia, 1998; Vera & Rodriguez-Lopez, 2004).Efforts must be made to identify ways in which a cultural humilityperspective can be embraced and promoted. Likewise, effort must bemade to uncover barriers and obstacles within the organization thatinhibit a cultural humility approach. Written plans, training, andorganizational support are called on that hold the organizationaccountable to the diverse make up and needs of the communitybeing served.

Crossing Cultural Boundaries and Bridging CulturalPerspectivesThe authors depict the interacting space between the client andworker in a manner consistent with Lee’s (2010) notion of the “areaof therapeutic interaction” (p. 276). Figure 1 depicts two separatecircles interacting within larger concentric circles. The extremeouter circle represents the boundaries of the society people share; inwhich people all live, affirm, and reinforce their own familiar cultural


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experiences. In this societal space, they also encounter new culturalexperiences that they may ignore, accommodate, or assimilate.

As members of specific communities and working within thechild welfare system, represented by the inner circles, the child wel-fare worker is held to the responsibility of assuring child safety andpermanence, and well-being. As representatives of the child welfaresystem, workers are educated and trained according to policies, pro-cedures, and practices that guide their professional actions. Inter -actions between the worker and client must take into account eachother’s “positionality” and power/authority differences. Explicit (andimplicit) interactions between the worker and client, located in theextreme inner circle of the figure, require some appreciation of thediffering power, authority, and positionalities that each hold. A cul-tural humility perspective draws attention to this interacting space,both figuratively and literally, in which bridging differences occurs.


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Figure 1Bridging Perspectives

Both the child welfare worker and the client bring their history andcultural experiences to their interactions. Each views the encounterthrough his or her own lens or worldview. What they share as acommon purpose is a concern about the well-being of the child. It isthe responsibility of the child welfare worker to bridge their differ-ing perspectives.

The authors have identified some essential worker skills for bridg-ing perspectives. They are defined next along with examples of theirapplication.

Skills for Bridging PerspectivesIn demonstrating cultural humility, the authors point to at leastfour essential skills: active listening, reflecting, reserving judgment,and entering the client’s world. Each of these skills finds support inthe social work practice literature although the authors think theyare especially important in demonstrating cultural humility. Whatfollows is a description of these skills in the context of a culturalhumility perspective followed by case examples that illustrate theirimportance.

Active ListeningActive listening is the tangible feedback that indicates to the clientthat a person is, indeed, listening (Hepworth et al., 2010). Active lis-tening focuses attention on to what the person is saying using headnods and utterances, such as Rogerian “umhum,” “I see,” and “okay,”that indicate the worker is attending to the client. Repeating state-ments and offering equivalent reflections of the person’s narrative isespecially relevant from a cultural humility perspective.

Case Example—SherrySherry is a young, single, African American mother who droppedout of high school, works in fast-food restaurants, and continuouslyfinds herself and her three children in homeless shelters due to herunstable income. Protective services removed her children from hercustody while living in a shelter because they were unsupervised,even though Sherry was in another location in the shelter trying to


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arrange job interviews while her oldest child, age 9, watched the twoyounger, preschool aged children. In an interview with a worker,Sherry described with intense frustration the removal of her chil-dren, the court process, and placement of her children into a whitefoster home in a separate county approximately 15 miles away. Shewas incensed that the judge asked her about her children’s fathers—men who had never provided support—in an effort to assess theirability to support the children. She complained vociferously aboutthe fact that at a recent foster home visit one of her children hadblisters on his toes from wearing shoes that were too small. Althoughthe foster care worker could have focused on Sherry’s neglect of herchildren and what was needed to get them back, and consideredSherry’s blaming the system as avoidance of her own responsibility,the worker did not. Instead the worker listened intently, noddingand saying, “This sounds very upsetting to you, especially theassumptions being made about your own parenting.” Sherry becameeven more animated and talked about her own childhood and howhard she was trying to make her own children’s lives better than herown. The worker could see the situation from Sherry’s perspective, asingle disempowered mother, limited to minimum wage jobs becauseof race, class, education, and gender, and struggling to provide shel-ter, food, clothing, and child care for her three children. The fostercare worker could genuinely understand why Sherry was upset andused active listening skills to demonstrate her willingness to hearSherry’s story from Sherry’s perspective.

ReflectingActive listening and reflective listening are sometimes used inter-changeably. From the authors’ perspective, reflecting deserves specialconsideration because they want workers to appreciate the two sep-arate issues relevant to reflection. First, reflection challenges theworkers to demonstrate that their understanding of what is being saidis consistent with the meaning intended by the client. It is not a sim-ple matter of repeating or summarizing the words of the client.Reflecting is a search for the meaning of what is being said by theclient; it requires an openness that allows what is being said by the


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client to be heard and appreciated. The second aspect of reflectionrests with the client him- or herself. A metaphor for reflecting is amirror. The mirror reflects not what is in the mind of the worker—itis a reflection back to the client of what the client has said. This sec-ond component is critical—it challenges the worker to hear what ismeant from the client’s perspective. Cultural humility on the part ofthe worker encourages the worker to do their very best to “hold themirror up” with the understanding that the lens through which theclient views (and speaks about or represents in nonverbal ways) theirworld is uniquely their own.

Case Example: JungJung, is an Asian American father of two boys, ages 8 and 6. He andhis non-Asian wife are in the process of divorce. The boys’ mothertook the boys and fled from her husband to the local domestic vio-lence shelter. She told shelter staff that her husband not only ter-rorized her sons but was violent with her. The boys also exhibited alot of sexual behavior problems in the shelter, exposing themselves,and touching each other’s privates. The shelter filed a report withchild protective services. The protective services worker interviewedthe boys and the mother at the shelter. The sons accused their fatherof physical and sexual abuse, but provided few and inconsistentdetails about their abuse. They clearly evidenced a great deal of fearof their father. The eight year old spontaneously described a timewhen his father hit his mother with a lamp and cut her forehead.

The protective services worker is now interviewing the father.The worker asks about any violence in the parental relationship. Jungsaid that his wife and he mostly had verbal fights—about three a day.Jung then asserted his wife was violent toward him, but he was neverviolent toward her. He said that one time she hit him in the headwith a lamp and slapped him several times. He stated that his 8-year-old son observed his mother hit him with a lamp.

Resisting the natural inclination to respond with the son’s version,the worker reflected back, by saying, “You said she was violent towardyou and hit you with a lamp and then she slapped you.” Jung vigor-ously affirmed this version of events and became teary-eyed. The


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worker then followed up with, “This seems upsetting to you; let’spause for a moment and talk about that. . . .” Jung immediately beganto talk about the impact his marital discord had on his relationshipwith his own parents, and he also had imagined raising his sons tocarry on important cultural traditions, including language. To himit was the cumulative loss of family, loss of dignity, and the respon-sibility he assumed in carrying on cultural traditions. He acknowl-edged the firmness in which he parented his sons and maintainedhis role as head of the household but vociferously denied allegationsof sexual abuse.

It is perhaps more challenging to try to bridge perspectives witha parent accused of domestic violence, physical, and sexual abuse, butthe worker needed to obtain all perspectives. The worker is challengedto seek Jung’s view of his world—especially his cultural world—toassess his current situation including his perception of himself ashusband and parent, and his perception of how others might viewhis situation.

Reserving JudgmentReserving judgment requires a conscious effort to listen intently onwhat is being said, appreciating the content while withholding theapplication of values judgments or beliefs that may compete withthe values and beliefs of the client. Being judgmental would includeprematurely reaching conclusions, letting one’s mind wander to hisor her own perceptions as he or she applies the client’s expressed con-cerns to one’s own life or professional training, making assumptionsabout blame or fault, or applying information obtained elsewhere(e.g., case records) as the frame of reference on which to judge theaccuracy of what the client is saying. Reserving judgment requires aconscious effort to remain open to the perspective of the other withan acute awareness of one’s own potential biases.

Case Example: MarkMark, a 6-year-old African American boy, whose parents were bothprofessionals, reported when interviewed at school that his fatherhad “put clampers on his arms” (squeezed him so tight that he had


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bruises—which the protective services worker could see and pho-tographed), hit him on his back (again there were a couple of bruisesthe worker photographed), repeatedly put his penis in his “butt,”“smeared poop” on him, and made him “eat poop.” The first two asser-tions were consistent with the boy’s physical condition, and Markcould describe in detail circumstances surrounding the physical abuse.Regarding the latter allegations, the worker wondered if Mark wasembellishing the extent of his abuse, especially given Mark’s matter-of-fact presentation of these allegations and difficulty in detailingtheir occurrence. Rather than challenging Mark’s assertions, theworker remained silent and considered multiple hypotheses thatmight explain his allegations. The hypotheses for the statementsabout the physical and sexual abuse included (1) that all the allega-tions were a reality, (2) that these allegations combined reality anddistortions related to trauma, and (3) that they are a distortion, withthe harshness of the described behaviors having cultural implications.This boy appeared desperate for help; he needed a response from aworker who did not prematurely reject the boy’s report. Reservingjudgment allowed the worker to consider many factors to account forthe allegations, including cultural considerations.

Enter the Client’s WorldSometimes referred to as “joining” (Minuchin, 1974), the child wel-fare worker is challenged to place him- or herself in the context ofthe client’s world (and as part of their culture and cultural experi-ence), accommodating to the cultural style of the client, experienc-ing to the best of their ability the client’s own cultural view as an“insider.” More so than that, in child welfare, the authors advocatefor workers to consider the diverse challenges and strengths the clientbrings to the helping setting. By entering the client’s world, theworker is challenged to experience it from the perspective of the clientwithout physically, psychologically, or emotionally retreating.

Case Example: Winona FamilyThe family of Winona, a Native American mother, is involved in boththe delinquency system and child protective services. One of her five


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sons, Trice, age 14, with a history of minor delinquent acts, hasadmitted to sexually molesting a 4-year-old half-sister. Winona’srecent reconnection with her Native heritage had given her a newperspective on life. She wanted Trice’s treatment to incorporateNative American traditional healing methods. The dilemma was thatthe Native American agency that offered traditional healing did nothave expertise in adolescent sex offender treatment, although theyhad two therapists who had attended Making Medicine, an adapta-tion of trauma-focused cognitive behavior therapy (for sexual abusevictims) that incorporates traditional Native healing and rituals. Thechild protection and delinquency worker spent two hours listeningto Winona describe her journey to tribal reconnection that includedher own recovery in a Native American substance abuse treatmentprogram. The worker listened to Trices’ descriptions of his participa-tion in powwows, following the seven grandfather’s gifts, and his tripback to his mother’s reservation. The worker came to the conclusionthat traditional native healing and supporting Trice’s connection tocultural role models would be important for the family, perhapsdiverting him from a delinquency pathway. They recommended tothe court a coordinated combination of treatment and services fromthe Native American agency and adolescent sex offender treatment,which was approved.

Although these essential skills for bridging worker and clientperspectives are described as separate and discrete, they are integratedaction steps for approaching clients from a cultural humility per-spective. Workers can apply these skills to form working allianceswith clients and provide more culturally relevant and sensitive serv-ices while promoting child safety, permanency, and well-being.

Summary and Practice ImplicationsThis article briefly discusses the rationale for the cultural humilitytraining provided to child welfare workers. The authors believe theconcepts, multiculturalism, intersectionality, and cultural humility shouldbe incorporated in child welfare worker training and practice. Theauthors agree with the perspective in child welfare that reinforces


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placing an emphasis on culture in all aspects of child welfare work.Institutionalizing training that draws attention to cultural differencemeans that the child welfare system fully appreciates the relation-ship between culture, parenting, and family well-being. A culturalhumility perspective draws attention to the fact that an appreciationof culture is beyond what can be accomplished by cultural compe-tence alone. It is a call to recognize the uniqueness of each individ-ual involved in delivering child welfare services. It defines a place forthe children and families, themselves, to become an integral part ofthe service delivery process with recognition of their unique andindividual definitions of self and place in society. It is, furthermore,a call for workers to lend expertise about culture to the clients whoare in the best position to define for themselves the meaning of theirculture and cultural experiences.

The authors present the following practice principles as derivedfrom key aspects of a cultural humility approach:

1. Embrace the complexity of diversity. In day-to-day existence,people occupy multiple positions with related identities andstatuses. These identities operate together (intersect), to dis-tinguish people as individuals. Intersecting group member-ships affect people’s expectations, quality of life, capacities asindividuals and parents, life chances, and so on. They drawattention to the whole person, power differences in rela-tionships, different past and present experiences based onpositionalities and social contexts, and potential resources(or gaps).

2. “Know thyself ” and critically challenge one’s “openness” to learnfrom others. Child welfare workers are urged to engage in aprocess of realistic, ongoing self-appraisal of cultural experi-ences and biases and stereotypes about self and self in rela-tionship to other cultures. Workers must assess the barrierstheir own attitudes and behaviors present to learning fromothers about others since personal knowledge alone will notsustain new insights, awareness, and behavioral change.

3. Accept cultural difference and relate to children and familiesin ways that are most understandable to them. Cultural


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humility encourages a less deterministic, less authoritativeapproach to understanding cultural differences, placing morevalue on the child and family’s own cultural expressions ofconcern and perspective. Communication skills and cultur-ally appropriate interaction techniques are expected to reflectthe clients’ unique experiences, thus reducing the worker’sneed to master completely the wide range of cultural beliefsand practices.

4. Continuously engage in collaborative helping. Worker involve-ment must be considered an ongoing process rather than out-come. In addition, workers must be involved in mutuallybeneficial, non-paternalistic and respectful working relation-ships with families, and become sensitized to factors at playin defining important priorities and activities needed toachieve child and family safety, stability, and well-being.

5. Demonstrate familiarity with the living environment of chil-dren and families being served. Child welfare workers arechallenged to learn to identify, understand, and build on assetsand adaptive strengths of children and parents and perhapsengage in efforts to disrupt or dismantle the kind of socialforces that act to disenfranchise and disempower them asmembers of society.

6. Build organizational support that demonstrates culturalhumility as an important and ongoing aspect of the work itself.Cultural humility should include an assessment of the orga-nizational environment, policies, procedures, knowledge, andskills connected to worker practices. Effort must be made toidentify ways in which a cultural humility perspective isembraced and promoted. Likewise, effort must be made touncover barriers and obstacles within the organization thatinhibit a cultural humility approach.

The most serious breech to culturally responsive practice is not somuch the lack of knowledge of the details of any given culture, butthe worker’s inability or unwillingness to develop self-awareness anda respectful attitude toward diverse and multiple points of view. It isthe failure to take into account the cultural expertise of others, about


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themselves, that ought to raise concern about our presumptions ofcultural competence. Cultural humility requires attitudes, beliefs andactions that invite new information and new perspectives on anongoing basis. It invites an acceptance of “not knowing,” and thewide range of cultural lenses that guide, sustain and reinforce ouruniqueness. Through collaborative helping, it promotes a sharedresponsibility for understanding child welfare concerns and for themutual discovery of effective change that supports cultural familiar-ity and that leads to child welfare’s mission of safety, permanence,and well-being.

References

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Cultural Humility for Child Welfare Professionals: A Paradigm Shift

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