Page 83 - Nutrition Counseling and Education Skills: A Guide for Professionals

• Do all groups participate in the normal socialization and networking during work hours?
• Are English-speaking employees impatient with those who speak English slowly or poorly?
• Are different cultural mannerisms and body language accepted or misunderstood and ridiculed?
• Are all people treated with patience, tolerance, and understanding?
• Are training materials and sessions planned with the idea of being understood by all?

Cultural Competence Models

There are numerous definitions of cultural competence and ways for a person to achieve it. One model
identifies three characteristics of a culturally competent professional as: (1) The professional is aware of his or
her assumptions, values, and biases, such as ageism, sexism, or racism. (2) The professional understands the
worldview of culturally diverse clients and their values and assumptions about human behaviors. (3) The
professional develops appropriate intervention strategies and techniques for culturally different clients.6 For
example, self-disclosure may not be compatible with some groups such as Asian Americans, Hispanic
Americans, and American Indians, gays, lesbians, bisexual, or transgender. Interpersonal communication may
require different verbal and nonverbal approaches and responses. The above model defines cultural
competence in terms of awareness, knowledge, and skills. To be effective, counselors must recognize their
biases, develop knowledge of the groups that they work with, and develop culturally appropriate intervention
strategies for different groups. While one cannot be knowledgeable of every possible group, professionals must
become knowledgeable of those groups seen most often. As products of our own cultural conditioning, often
Euro-American, we must guard against negative opinions of the lifestyles of other groups.

The ETHNIC model is another model of culturally competent care. It includes the six steps of (1)
Explanation, (2) Treatment, (3) Healers, (4) Negotiation, (5) Intervention, and (6) Collaboration. Explanation
asks the client to explain his or her illness to determine client understanding. Treatment inquires what
treatment the client expects and what he or she may eat or avoid to stay healthy. Healers inquires whether the
person has used nontraditional sources. In the Negotiation stage, one collaborates with the client to find
acceptable treatment choices. Intervention asks for client feedback on the treatment choices and any concerns.
Collaboration discusses the help from other healthcare team members or community and family resources.6

Professionals may inquire about foods purchased for the family.

83