Cultural Humility: A Lifelong Practice

Melinda Hohman, Ph.D.

Social work as a profession places a great deal of emphasis on diversity and cultural competency. The National Association of Social Workers Code of Ethics (NASW, 2008) states that:

a) Social workers should understand culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.

(b) Social workers should have a knowledge base of their clients’ cultures and be able to demonstrate competence in the provision of services that are sensitive to clients’ cultures and to differences among people and cultural groups.

(c) Social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability.

There are several different aspects to this ethical standard. One is its emphasis on knowledge. Cultural competency begins with having knowledge of different cultures or aspects of social diversity. However, knowledge alone is not enough. As indicated in the ethical standard, social workers need to be able to use their knowledge to respond to clients in a helping, culturally supportive manner (Ortega & Coulborn Faller, 2011). Unfortunately, how we respond is often a gray area of practice: what does it mean to “demonstrate competence in the provision of services”? The standard also asks us to provide these services with respect for individual differences. How do we know that we are using our cultural knowledge regarding different races, gender expression, age, and the like, in a way that meets the needs of the individual client?

One approach that has been developed is that of cultural humility. Developed initially for physician training (Tervalon & Murray-Garcia, 1998), it has been expanded to the social work field (Ortega & Coulborn Faller, 2011; Schuldberg et al., 2012). Humility in this sense is not being weak or submissive but having a sense that one’s own knowledge is limited as to what truly is another’s culture. We are limited because we have unconscious stereotypes of others and tend to use stereotypes as a “safety net” to help explain behavior (Ortega & Coulborn Faller, 2011). We are also limited as we can’t know everything about every culture and because our clients are complex humans who intersect in a variety of cultures, be they race, gender, class, age, work status, disability status, etc.
Cultural humility is about accepting our limitations. Those who practice cultural humility work to increase their self-awareness of their own biases and perceptions and engage in a life-long self-reflection process about how to put these aside and learn from clients (Tervalon & Murray-Garcia, 1998). The social worker is not the expert but the learner and the self-reflection process enables the social worker to determine what attitudes and values keeps him or her from learning from the client (Ortega & Coulborn Faller, 2011). Clients are approached humbly and are viewed as collaborators in the helping process. Clients teach us about their unique places at the intersections of their different cultures and the role of the social worker is to be willing to learn about their experiences. Ortega and Coulborn Faller (2011) write that it is this openness (humility) to learn that “frees” social workers from having to be experts and feel that they must know everything about various cultures.

How do we learn from our clients? Those who practice cultural humility view their clients as capable and work to understand their worldview and any oppression or discrimination that they may have experienced as well. They use their best communication skills—open-ended questions and reflective listening—to explore their concerns, thoughts, and ideas. They keep ourselves from providing advice or direction as though we were the experts in their lives. When they want to do this, those who practice cultural humility stop themselves and examine their intentions (Ortega & Coulborn Faller, 2011). Reflective practice involves the continual challenging of oneself and an openness to learning from those we serve.

References

Ortega, R. M., & Coulborn Faller, K. (2011). Training child welfare workers from an intersectional cultural humility perspective: A paradigm shift. Child Welfare, 90(5), 27- 49.
Schuldberg, J., Fox, N. S., Jones, C. A., Hunter, P., Mechard, M.,…Stratton, M. (2012). Same, same but different: The development of cultural humility through an international volunteer experience. International Journal of Humanities and Social Science, 2 (17), 17- 30.
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9 (2), 117-125.

Dr. Hohman is a Professor at the School of Social Work and teaches courses in Social Work Practice, Motivational Interviewing, and Substance Use Interventions.