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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.