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140

JCPSLP

Volume 18, Number 3 2016

Journal of Clinical Practice in Speech-Language Pathology

example, over time, a woman may perceive herself to be

limited as an individual due to her social experience – her

self-concept is altered. This theory highlights the importance

of considering cultural competence as a multidimensional

and fluid concept, requiring constant adaptation as we

consider individuals within a culture. However, the stand-

alone models currently do not reflect this essential

relationship between practitioner awareness, knowledge

and skills and their interaction with the individual client.

Model 2. Papadopolous, Tilki, and

Taylor (1998)

Papadopolous, Tilki, and Taylor (1998) describe similar

attributes for cultural competence as Sue et al. (1992) but

also identify “cultural sensitivity” as a key component,

Theoretical models of cultural

competence

This section explores two prominent models of cultural

competence and their application to trans-cultural

speech-language pathology practice. The models were not

specifically designed for speech-language pathologists, but

can be applied to allied health professions more broadly.

Model 1. Sue, Arrendondo, and

McDavis (1992)

Sue, Arrendondo, and Davis (1992) identified three dimensions

necessary for cultural competence: (a) awareness/beliefs,

(b) knowledge, and (c) skills. These three dimensions are

complementary to three practitioner characteristics: (a)

awareness of own assumptions, values and biases; (b)

understanding of the worldview of the culturally different

client; and (c) use of appropriate intervention strategies. The

relationship between each dimension can be visualised in a

matrix to represent the competencies required to be

considered culturally proficient (Table 1).

In addition to their model of professional cultural

competence, Sue et al. (1998) use the concept of “multi-

dimensionality of identity” to define how individuals possess

different identities at individual, group, and universal levels,

with the potential to possess more than one identity at each

level

3

(Ridley, Baker, & Hill, 2001). Moreover, they describe

how these identities are interactive – a person may be

socially limited or liberated by one or more of their identities

at each level, depending on their experience. For example,

a woman with a communication disability’s participation in

society

may

be limited by both her disability and her gender

at group or universal level, but not at individual level. A

person’s experience at one level may, over time, alter identity

at another, including the way a person views his/herself as

an individual (Marsh & MacDonald-Holmes, 1990). For

Awareness and beliefs

Clinician is:

Knowledge

Clinician demonstrates:

Knowledge of own culture and

aspects of this that may impact

upon service delivery to diverse

populations

Knowledge and understanding of

different cultural interpretations

of worldviews and understands

that individuals within a culture

may have individualised

interpretations of their own

culture(s).

Desire to develop knowledge and

understanding

Knowledge of how to adapt

intervention strategies and

techniques to a variety of

populations using culturally

appropriate and acceptable

methods.

Support-seeking from others with

implicit cultural knowledge

Skills

Clinician is:

Aware of own skills and ability

to adapt these to diverse

populations.

Aware of own learning needs in

relation to skill development

Able to transform understanding

of different worldviews into

culturally sensitive and safe

clinical practice

Skilled in innovative, sensitive

and safe intervention

Table 1. Dimensions of culturally competent practice proposed by Sue et al. (1992).

Dimensions

Practitioner

characteristics

Awareness of own

assumptions, values and

biases

Understanding of the

worldview of the culturally

different client

Use of appropriate intervention

strategies

Aware of own culture and its

influence on beliefs about self,

others and clinical practice

Aware that individuals have

varied understandings of the

world and that this may impact

upon the conceptualisation of

their difficulties and response to

intervention.

Respectful of difference in the

face of own cultural values and

beliefs.

Aware of the need for flexibility,

creativity and individualisation in

intervention

Individual

identity

Universal

identity

Group

identity

SELF

CONCEPT

Figure 1. The interrelationship between levels of

multidimensional identity and self-concept.