In addition, ethnic and cultural concepts may clash with mainstream values inherent to traditional psychotherapies. They propose that psychotherapy itself is a cultural phenomenon that plays a key role in the treatment process. For example, Bernal & Scharroón-Del-Río (2001) maintain that ethnic and cultural factors should be considered in psychosocial treatments for many reasons. The delivery of quality services is especially difficult because of cultural and institutional influences that determine the nature of services. (2003) advocated that ethical standards mandate cultural competence via collaboration with, and sometimes deference to, ethnic minority communities and experts. As an alternative to the passive “do no harm” approach in ethical standards in many helping professions, Hall et al.
Ridley (1985) has argued that cultural competence is an ethical obligation and that crosscultural skills should be placed on a level of parity with other specialized therapeutic skills.
Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices. Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists. For example, one of the guiding principles of the American Psychological Association (2002, pp.
The goals of many professional organizations include equity and fairness in the delivery of services. Justice or ethical grounds have also propelled cultural competency ( Whaley & Davis 2007). The disparities exist because of service inadequacies rather than any possible differences in need for services or access-related factors, such as insurance status ( Smedley et al. Racial and ethnic minorities receive a lower quality of health care than do nonminorities, have less access to care, and are not as likely to be given effective, state-of-the-art treatments ( U.S. Compared to white Americans, ethnic minority groups were found to underutilize services or prematurely terminate treatment ( Pole et al. The evidence revealed that mental health services were not accessible, available, or effectively delivered to these populations. Further troubling were the welldocumented health status disparities between different ethnic and racial groups, as well as the nationally publicized studies regarding cultural bias in health care decision making and recommendations ( Schulman et al. population, which necessitated changes in the mental health system to meet the different needs of multicultural populations. These concerns were prompted by the growing diversity of the U.S. Appeals for cultural competency grew out of concerns for the status of ethnic minority group populations (i.e., African Americans, American Indians and Alaska Natives, Asian Americans, and Hispanics). Many prominent health care organizations are now calling for culturally competent health care and culturally competent professionals ( Herman et al. We have not attempted to be exhaustive in our review of the relevant research instead, we have examined the major issues and trends in cultural competency. This review examines many of the key issues surrounding cultural competency-namely, its definition, rationale, empirical support, and effects. Yet, the concept has also been a source of controversy concerning its necessity, empirical research base, and political implications. Originally conceptualized as cultural responsiveness or sensitivity, cultural competency is now advocated and, at times, mandated by professional organizations local, state, and federal agencies and various professions. Multiculturalism, diversity, and cultural competency are currently hot and important topics for mental health professionals ( Pistole 2004, Whaley & Davis 2007). The notion that culturally competent services should be available to members of ethnic minority groups has been articulated for at least four decades.