Rethinking Social Work Practice with Multicultural Communities

Yolanda C. Padilla, Ruth McRoy, Rocío Calvo, Yolanda C. Padilla, Ruth McRoy, Rocío Calvo

• Publisher: Routledge
• Year: 2020
• eBook ISBN: 9781000709810
• Topic: Education
• Subtopic: Health Care Delivery

With research showing that clients from diverse racial and ethnic groups disproportionately experience barriers in their interactions with social services and that providers recognize the need to be better prepared to work with these groups, this book invites us to rethink current approaches to social work practice with multicultural communities.

We begin with a synthesis of the current evidence on the provision of care to multicultural communities that provides an in-depth look at both client and provider experiences. The following chapters offer tangible, research-based approaches to engaging with multicultural clients and reveal often unrecognized problems with current models of social work practice. A unique compilation of rigorous qualitative, experimental, and community-based studies demonstrate the effectiveness of culturally grounded interventions and identify the specific factors associated with positive outcomes. Areas covered include disability, marriage and couple relationship problems, domestic violence, and mental illness within Latinx, African American, First Nations, and South Asian communities. As the authors in this book show, the stories of multicultural communities are narratives of unprecedented resourcefulness and reinvention. Yet, social work underutilizes rich family and community cultural resources. By not facilitating their involvement, social service systems compromise these vital resources which social services cannot replace.

In arguing that we need to expand professional boundaries to encompass indigenous practices, family and extended kin, and therapeutic relationships that make sense to different cultural groups, this book will be of interest to those studying the ways in which social work practice can be improved to better suit the needs of a racially and ethnically diverse population.

This book was originally published as a special issue of the Journal of Ethnic & Cultural Diversity in Social Work.

State of the art in U.S. multicultural social work practice: Client expectations and provider challenges

Katarzyna Olcoń

ABSTRACT
To obtain a comprehensive view of the level of knowledge and development achieved in multicultural social work practice, I conducted a scoping review of U.S. empirical literature for the 10-year period from 2007 through 2016. The review revealed that across the board racial and ethnic minority clients continue to experience marginalization and report low satisfaction with services. Conversely, providers are subject to some tensions and biases toward multicultural practice exacerbated by employers’ lack of emphasis on cultural competence. The problematic findings from the review suggest that our current approaches to cultural competence may need to be reexamined.

Introduction

In the United States, social work providers and other helping professionals, such as counselors or youth workers, frequently work with clients who come from a variety of racial and ethnic backgrounds. There is consensus in the literature that service providers’ ability to work across cultural differences is important for racial and ethnic minority clients (Sue, Rasheed, & Rasheed, 2015). According to Wilkinson-Lee, Russell, and Lee (2006), service providers play a crucial role because “[they] are the individuals who shape the cultural sensitivity of any prevention program on a daily basis in their professional lives” (p. 385). Thus, the social worker’s beliefs, values, worldviews, and ways of knowing are an essential component in the efforts to provide authentically culturally sensitive and relevant social services.

Despite educational preparation on cultural competence (Council on Social Work Education [CSWE], 2015) and ethical requirements (National Association of Social Workers [NASW], 2017), a look at the literature on minority client outcomes suggests gaps in the translation to practice. Racial and ethnic minority individuals are less likely, for example, to receive high-quality mental health care (McGuire & Miranda, 2008), substance abuse treatment (Guerrero, Marsh, Khachikian, Amaro, & Vega, 2013), and referrals to social services from the juvenile justice system (Spinney et al., 2016). In a comprehensive overview of the issues African-Americans face in mental health services, Briggs, Briggs, Miller, and Paulson (2011) detailed the many institutional inequalities and cultural insensitivities, such as lack of minority representation among mental health professionals, that result in underutilization of services.

Few efforts have been made to synthesize a body of knowledge related to multicultural social service provision. A major “state of the art” work was offered by Schlesinger and Devore (1995), where the authors reviewed 10 years of literature on ideological, theoretical, and practice issues related to ethnic-sensitive social work practice. In a more recent work, Kohli, Huber, and Faul (2010) provided a detailed summary of the historical and theoretical development of culturally competent social work practice. No review has been conducted, however, of the empirical evidence as related to cultural competence of social service providers and the satisfaction and experiences of service recipients of racial and ethnic minority groups.

To address this gap and to obtain a comprehensive view of the level of knowledge and development achieved in multicultural social work practice, I take stock of the evidence from existing research. The results are presented from a scoping review of empirical literature that assessed the outcomes and experiences with multicultural practice of racial and ethnic minority clients and social work providers. Examining the perspectives of both clients and providers allows for a comprehensive profile of the current state of the art and provides a useful framework for analysis. Together, consumer perspectives and provider firsthand accounts of the challenges that arise in the provision of care can help us generate patient- and client-centered and culturally relevant practices (Carpenter-Song, Schwallie, & Longhofer, 2007). The aim of the study is to inform ways to better meet the needs of historically excluded racial and ethnic groups and to critically evaluate the impact of theoretical foundations and principles of cultural competence in the field.

Conceptualizing multiculturalism and culture

The concept of multicultural practice is extensive and includes many groups, such as women, racial and ethnic groups, gay, lesbian, bisexual, and transgender (GLBT) individuals, people with disabilities, religious minorities, and others (Sue et al., 2015). The focus of this article is on racial and ethnic diversity only in social service provision in the United States. Practice with culturally diverse populations is influenced by different epistemologies that guide the way culture is conceptualized (Williams, 2006). From the critical perspective, culture is viewed as a tool of power of one group over another (e.g., Williams, 2006). This definition of culture has been widely embraced in some parts of the world, such as Latin America, which has been more critical of oppressive power structures (Freire, 1970). In the United States, the literature of helping professions, such as social work, tends to portray culture predominantly in terms of values, beliefs, customs, and acculturation, frequently overseeing the sociohistorical context of the clients, particularly economic disparities. According to Viruell-Fuentes, Miranda, and Abdulrahim (2012), from this perspective culture tends to be essentialized and pathologized and is used as a tool to obscure structural barriers and limited life opportunities.

The conceptualization of culture that guides this article integrates both structural context and individual worldviews based on Taylor’s definition of culture as “the story of the person”—that is, “what people think and say, and what they have experienced” (2003, p. 177). This definition implies that culture is the entirety of a person’s lived experience, which includes but is not limited to one’s worldviews, values, and behaviors. An important aspect of “the story of the person” is his or her life context and life opportunities, which are always shaped by power dynamics and social structures.

Methods

The purpose of this scoping review was to provide a synthesis of empirical literature on racial and ethnic minority clients and social service providers, in terms of their expectations, experiences, outcomes, and challenges in multicultural social service encounters. The scoping review method allows for addressing a broad topic based on the analyses of studies using a variety of designs and without restrictions based on quality indicators (Arksey & O’Malley, 2005; Levac, Colquhoun, & O’Brien, 2010).

The scoping review covered research studies conducted in the United States in the 10-year period from 2007 through 2016. Inclusion criteria for client studies were as follows: (a) satisfaction and/or experiences of racial and ethnic minority clients in multicultural services; (b) health and social services settings, such as child welfare, mental health, and substance abuse treatment; and (c) social workers and other helping professionals. This criterion allowed for capturing the experiences of clients in typical service settings, which requires client interactions with a range of professionals. In terms of the studies on service providers, inclusion criteria were as follows: (a) providers’ levels of cultural competence and factors associated with it; (b) providers’ experiences in working with racial and ethnic minority clients; and (c) health and social service settings.

Original research studies were reviewed separately and the results mapped out for each of the two study groups—clients and providers. Research citations were searched in Social Services Abstracts, PsycINFO, Academic Search Complete, PubMed, and Web of Science with the combination of search terms such as “social worker*” “social work provider*”, race, cultur*, multicultur*, divers*, “client satisfaction”, empirical, qualitative, and quantitative. After identification of relevant articles, the references of each article were hand searched for other studies that fit the inclusion criteria.

Results

A total of 23 studies met the inclusion criteria for the client group (see Table 1) and 26 for the providers group (see Table 2). The client studies included 11 quantitative and 11 qualitative studies, and one mixed-methods study. Among the providers studies, 12 were qualitative, 12 were quantitative, and two were mixed methods. In total, 12 of the studies were doctoral dissertations and two were master’s theses. All others were reported in peer-reviewed articles. The findings of the scoping review are synthesized next, beginning with the guiding theories and methods utilized and the characteristics of the sample of studies included in the analysis. The factors affecting racial and ethnic minority client satisfaction and the provider experience in terms of achieving cultural competence are then summarized.

Guiding theories and methods

One of the most frequently utilized theoretical frameworks to guide the research studies on multicultural practice for both clients and providers was the cultural competence model. Some of the other guiding theories included social constructionist theory, critical race theory, and the White Racial Identity Development Model (Helms, 2002). The majority of the studies, however, did not specify their theoretical grounding. Some cited literature on concepts such as multiculturalism, racism, social justice, racial disparities in health and health care, or bilingual and bicultural human service provision.

The sample in the clients’ studies ranged from eight to 210 in the qualitative studies and 24 to 5,002 in the quantitative studies, and was 83 in the mixed-methods study. Participants were mostly racial and ethnic minority clients, although several of the quantitative studies included White clients and analyzed the results by comparing the outcomes for the different groups. Some studies used national data sets while others recruited participants through local mental health organizations, hospitals, and social service facilities.

In the providers’ studies, the samples ranged from 6 to 56 in the qualitative studies, 81 to 1,124 in the quantitative studies, and 29 to 256 in the mixed-method studies. The participants were frequently recruited through regional and national social work organization listservs such as Council on Social Work Education and the National Association of Social Workers. The majority of...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Citation Information
• Notes on Contributors
• Preface: Rethinking practice with multicultural communities: Lessons from research-based applications
• 1 State of the art in U.S. multicultural social work practice: Client expectations and provider challenges
• 2 Parents Taking Action: Reducing disparities through a culturally informed intervention for Latinx parents of children with autism
• 3 A systematic review of culturally relevant marriage and couple relationship education programs for African-American couples
• 4 Cultural adaptations in psychosocial interventions for post-traumatic stress disorder among refugees: A systematic review
• 5 Experiences of African-American men with serious mental illness and their kinship networks within the mental health care system
• 6 A culturally grounded biopsychosocial assessment utilizing Indigenous ways of knowing with the Cowichan Tribes
• 7 “If we’re not serving our own community, no one else would”: The lived experience of providers in ethnically similar therapeutic dyads at South Asian women’s organizations
• Index