Deqa Jama explores the cultural competence framework – what it is, how to become culturally competent and why it should be a vital part of your approach to client care
Cultural competence refers to the capacity to understand and interact with people with social and/or linguistic backgrounds different from your own. In the context of legal practice, this is imperative to provide equitable and unbiased services to all clients, regardless of their identity or cultural background.
To Irena Papadopoulos et al., writing for the Journal of Compassionate Health Care in 2016, the three overarching tenets of cultural competency are: culturally competent compassion, culturally competent courage, and intercultural communication. They are pertinent – in a legal context – to providing better outcomes for clients and solicitors alike.
Customs and norms relative to your lived experience and environment might be entirely out of place elsewhere. This is not to say a certain set of norms and values is wrong, but they can sometimes exist in the ‘wrong location’. Problems arise when one regards their cultural practices as normal and all else as ‘deviators’ from said norm, creating a potential for an ‘us’ versus ‘them’ mentality. This is a dangerous path that is easy to start following. The way we communicate, especially given the power dynamics at play when providing legal representation, becomes paramount to the quality of service provided to clients, and whether this service encompasses equity, and benefits all clients – individuals and families in particular – irrespective of their identity.
To become culturally competent, a solicitor must first familiarise themselves with the concept of cross-cultural communication.
There are many benefits to thinking cross-culturally in legal practice. To effectively communicate cross-culturally, legal practitioners you need to show a willingness to consider wider worldviews – those that are familiar and acceptable to the client you’re representing – as equal to your own. There needs to exist a positive attitude toward cultural differences, and a readiness to accept – and respect – them.
When one assumes that all members of a particular culture, ability, ethnic group, or race act alike, stereotyping is at work. Stereotyping may be positive or negative, but even the positive ones must be examined to make sure your service is equitable for all clients you are representing. You know what you know – if your starting point is “this is correct” instead of “this is correct according to my experience”, then a downward spiral has already begun.
For the healthcare sector, cross-cultural communication is understood to provide substantial benefits to not only service users, but also organisations working within multicultural communities. Accredited by the certification service, Continuing Professional Development (CPD), Maguire Training maintains that “without this awareness, huge unintentional mistakes can be made which seriously impact on communication with patients from other cultures”.
An example is the case of Evan Nathan Smith, who was admitted into hospital for a procedure to remove a gallbladder stent. Sepsis is believed to have triggered a sickle cell crisis in the 21-year-old. After being denied a request for oxygen, he called 999 from his hospital bed. No paramedics were sent – he suffered multiple cardiac arrests and died two days later. It was concluded by the coroner, Dr Andrew Walker, that Mr Smith’s death was due to “a failure to appreciate the significance of those symptoms by those looking after Mr Smith at the time”. Sickle cell disease is known to be most prevalent among people from African-Caribbean backgrounds, and the hospital where Mr Smith was admitted serves an area with a large African-Caribbean community. Had cultural competency frameworks been embedded into hospital practice, this failure to recognise the seriousness of Mr Smith’s symptoms, and his death, may not have occurred.
The hospital now has a ward specifically for sickle cell patients and has implemented training for staff.
Teresa Odle of the American Society of Radiologic Technologists, remarks: “Patient-centred care is an approach to health care delivery emphasising engagement with patients and families, cultural competence, communication, and shared decision-making. When planned and implemented thoughtfully, patient-centred care leads to a slow and deliberate culture change in an organisation or department.”
Embedding these things into your firm can reduce instances of malpractice and discrimination (intentional or otherwise), while also increasing understanding and empathy in your client relationships. This should serve as an incentive for improvements through ongoing cultural competency training.
Being proud of your heritage is a wonderful thing, but for some, this can slip into something more negative. Ethnocentrism is “behaviour or beliefs that favour one particular culture and judge other cultures against it”. This is almost an antonym of cultural competence.
Wolfgang Aschauer and Jochen Mayerl conducted a study in 2019, in the European Societies Journal, on the dynamics of European ethnocentrism; it found Britain, as a society, among other countries, to have deep ethnocentric beliefs. Ethnocentrism can present itself in a multitude of ways, including the way in which we view the worth of one person over another, depending on their proximity to perceived Britishness. Cultural competence is crucial in mitigating this – without it, the opportunity to build meaningful relationships is much more difficult.
To correctly implement cultural competency frameworks into your practice as a solicitor, you must consciously understand and be aware of the extent to which you hold ethnocentric views – even where these views are subconscious. For instance, if a client is a devout Muslim woman and she does not accept a handshake, this may be viewed as a snub or sign of disrespect through a typically British lens, even after consciously understanding the reasoning behind it (many Muslim women prefer not to be touched by men). Viewed through a British lens might, despite knowing the reason for the action, you might interpret her as being rude or cold, potentially affecting the service she receives – all due to the solicitor seeing the handshake as the standard or norm.
Ethnocentrism narrows critical thinking skills, as one tends not to venture outside of their innately held beliefs. Peter A. Facione situated critical thinking within the context of cultural competency as a “purposeful, self-regulatory judgment which results in interpretation, analysis, evaluation and inference as well as explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations upon which that judgment is based”.
Peggy Wittman and Beth Velde argue that “there needs to be a focus on the interrelationships among cultural competence, critical thinking, and intellectual development. Until adequate consideration is given to how these three processes relate to each other, curricula may not achieve the development of culturally competent practitioners” – a comment made 19 years ago, that remains relevant today.
Missteps made due to our unconscious decisions are not necessarily because of any deliberate negative ‘ism’ in our thinking – but because we have never questioned what we deem acceptable and familiar, or we are not used to seeing these things as movable, dependent, and subjective to our own experiences. If our norms are thought of as movable concepts, you can learn to understand that there are situations where what you deem ‘wrong’ can be ‘right’ outside of your individual experience, and vice-versa. Then, you allow space for true understanding and respect of all persons and cultures. Cultural competency when providing legal services becomes incomplete and inconsequential without this understanding of how we view, navigate, and situate the subconscious.
It is important to understand that unlearning our subconscious ethnocentrism is unequivocally longer, and a much harder feat, than engaging our conscious and logical thinking. For instance, think of a time you knew you had to make a stop on the way home, but because you were tired, you ended up going straight home without a thought. When we are tired or frustrated, our subconscious can drive decision-making, and this is when cultural competence becomes urgently important – particularly for law firms, as these decisions can gravely impact clients in irreparable ways. Properly executed and ongoing cultural competency training can broaden the subconscious mind to see the accepted and familiar as subjective, thereby affording anything that might oppose these preconceived notions grace and value.
When working in practice, to be able to interpret behaviour or information without any assumptions is an important skill to nurture and enhance. This remains fundamental to reaping the benefits of cultural understanding – even when we think we understand, it is still within the realm of assumption until you have relevant information from an appropriate source. This could be asking for it – curiosity is proven to be well received and asking questions from a curious and sincere perspective is critical in cultural insight.
From a surface perspective, you can indeed respect what you do not know, but can you respect it entirely if it is in opposition to your personally held acceptable and familiar subconscious beliefs? This is an interesting note within the framework of cultural competency that is particularly vital when working in practice with people from differing walks of life, whether that be different in terms of gender, race, faith, socioeconomic standing, language, or any combination in terms of intersections of identity, for that matter.
Cultural competency is urgently important in providing the best outcomes for families
Intersectionality is a term that was coined by Kimberlé Crenshaw, an American lawyer, academic and civil rights advocate, in the late 1980s. It describes how race, class, gender, and other personal characteristics ‘intersect’ with one another, and often overlap. She wanted to remind people that when thinking about equality, we need to think beyond single attributes like skin colour or gender and recognise that humans often have more than one characteristic that is subject to discrimination or hostility. For example, while any woman may experience sexism, a black lesbian will be at risk of experiencing sexism, racism, and homophobia, all at once. For this reason, it is important not to fall into the trap of thinking that you can fully understand the lived experience of someone else. However, what you can do is to listen to and respect people when they share their lives with you.
Mary Dixon-Woods conducted research in 2006 surrounding vulnerable groups’ ability to access relevant healthcare, in the BMC Medical Research Methodology journal. The research suggests failings within services for several marginalised groups, making the implications of improper care greater. For example, black men were less likely to be able to access relevant services than white women. However, black women were more likely to be negatively impacted by inaccessibility than both black men and white women. This becomes even more pertinent when discussing families: the more persons involved, the more intersections and nuances in identity exist.
It is proven that those who are closest to your own acceptable and familiar beliefs will get the best representation out of you. Cultural competence with an intersectional approach – viewing others holistically – can enhance a client’s experience and improve quality for all those represented, as well as the overall experience for solicitors.
Importance of implementation
There exist elements that can impede equitable cultural understanding in practice; comprehending these barriers can help carve out the necessity for extensive training. There are two prongs to these impeding elements – one is organisational, or systemic, and one is individual. A practising solicitor is only fully able to dismantle the individual prong whilst the other remains. These systemic barriers can be birthed from an absence of structured organisational support, and a lack of skills to assess and address immediate disparities. A perceived shortage of work hours to dedicate has also been noted as a barrier, which is rarely truly the case. Engaging with cultural competency is just as important as reading relevant legal and policy-oriented papers. It is needed to do the job equitably.
Significance for the client
Adult individuals can be more vulnerable than children in some respects when navigating the legal sphere. Children will always be given (if rules are followed) a responsible adult in instances like police interviews. The vulnerability of an adult is not as clear-cut.
For example, mental health and neurodivergence (for example, autism or ADHD) may not be noticed, or even be diagnosed in adults. If an individual cannot convey themselves in the way a solicitor may need them to, whether because of a language barrier or in the way they process certain information, it can immensely affect the relationship. It is on the solicitor to bridge the necessary gaps, so an individual is not provided lower-quality service for factors outside of their control.
The National Autistic Society states: “Due to the difficulties autistic people have with communication and social interaction, a police interview can be extremely difficult. The person may appear very able, with a good or even exceptional vocabulary, and there may be no reason for an interviewing police officer to suspect that the interviewee requires additional help.” Further, the needs of vulnerable people for whom English is not their primary language for a responsible adult can be overlooked, too. This also occurs when non-English-speaking persons with disabilities and learning difficulties go ‘under the radar; due to these signs being conflated with their perceived ‘foreignness’.
Similarly, when working with families and children, cultural competency is fundamental in understanding family dynamics. This protects children from harm, either by being taken from good parents or being left in abusive situations. Cultural competency is urgently important in providing the best outcomes for families. From a psychotherapy perspective, children from cultures different to the practitioner are more likely to be misdiagnosed or suffer from unfair and biased decision-making. Further, it often gives the family a perceived lack of credibility with the professional – a loss of trust leads to limited further communications, hindering the level of service further.
Moving forward with cultural foresight
Michele Eliason and Salome Raheim expressed a point over 20 years ago, that still rings true today: “As awareness of racial and ethnic group oppression increases, students are less likely to voice publicly an opinion that might be construed as racist. It is difficult to determine whether racist attitudes have decreased, or whether ‘political correctness’ merely inhibits people from expressing them.”
There must exist a safe space for solicitors to investigate their prejudices safely and without fear of backlash, but more so, the focus and onus should be on institutions and organisations – they need to drive the change and realise that solicitors cannot possibly know everything without the right support, guidance, and education.
Our world landscape is changing, with thousands emigrating to, and from, the UK, and with it, the prospect to develop useful, multifaceted relationships grows. Ongoing learning (or unlearning), at both the individual and organisational level, as the cultural backdrop for understanding widens, is the differentiator between real and demonstrable cross-cultural skills and the virtue-signalling ‘tick box’ training programmes.
The field of cultural competency across industries and sectors is still growing and evolving exponentially, and more and more organisations and institutions are emphasising getting it right. Change is looming, and the benefits are starkly clear.