What does culture mean to you?
Tell me what is most central to your identity:
Is it your age?
… or something else?
If you had a hard time choosing one you probably, like most people, fit into more than one category. Oftentimes culture operates at a place of intersectionality. One box does not fit all areas of your cultural identity. Culture is the fabric that makes you who you are and is always evolving. But importantly, our assumptions about culture shape our interactions with our clients. These are the invisible biases that can prevent a clinician from being qualified to practice.
Traditionally as a field, we have focused on reaching cultural competence. But competence is just the first step toward a process of lifelong learning about culture. Cultural competence suggests that clinicians can complete a course or class to achieve competence, that learning could mostly end there, and/or that cultures are finite (which mostly just risks stereotyping individuals). This definition is problematic in our ability to serve diverse populations in this profession. A more encompassing term that involves self-reflection/self-critique, learning from others, partnership building, and the lifelong process of learning is “cultural humility.”
Tervalon & Murray-Garcia (1998) define cultural humility as a lifelong commitment to self-evaluation and self-critique that addresses the power imbalances in the patient–physician dynamic and focuses on developing mutually beneficial and non-paternalistic clinical and advocacy partnerships within communities. This model applies equally well to the profession of Communication Sciences and Disorders (CSD). We use models of caregiving that are often based on medical models in a variety of settings. The concept of cultural humility differs from the expectation of certified CSD professionals, which is that most will demonstrate cultural competency based on the standards of the American Speech–Language–Hearing Association (ASHA), our professional organization and certifying body. We now know that cultural competence is not a finite skill but should be considered an ongoing process that would be coupled with cultural humility known as “cultural competemility” .
As clinicians aim to achieve cultural humility, we must address the conscious and unconscious beliefs that shape our perspective of a particular culture. No one is part of a monolithic culture. In fact, our clients hold multiple identities that make them who they are. For next steps on this topic, please see the article “Moving forward as a profession in a time of uncertainty,” as well as future articles from us and contributors using the hashtag #AmIQualified.
We welcome other bloggers, thought leaders, and anyone interested in joining this discussion to use the hashtag #AmIQualified along with us to connect our conversations with one another.
members of The Informed SLP
Blog posts by title:
In a fog: Five facts + twelve clinical takeaways about chemo brain
#AmIQualified: Let’s talk about bilingualism and white supremacy in CSD, one layer at a time
#AmIQualified: Let’s talk about privilege in speech–language pathology
#AmIQualified: Let’s talk about moving from cultural competence to cultural humility
The Not-New Speech Norms Part 2: An American Tale
Motivational interviewing and behavioral change in clinical practice
Standardized language tests: That score might not mean what you think it means
The grammar guide you never knew you always wanted
Top 12 questions about ASHA CEUs—answered
Schools, safety, SLPs, and the evidence
Response to #BlackLivesMatter, 2020
COVID-19 and Dysphagia: Considerations for the Medical SLP
COVID-19 and Cognition: Impact for the Medical SLP
Looking for evidence on telepractice for SLPs?
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That one time a journal article on speech sounds broke the SLP internet
The difference between respecting our science and loving our science
What does the evidence show about treatment intensity?
EBP as a blame game
The EBP barrier nobody is talking about
Guest post: On evidence analysis
Guest post: On trauma and language development
Guest post: Working memory, processing speed, and language disorder
Guest post: Push-in services—how to collaborate!
Guest post: Complexity approach for speech sound disorders
How am I supposed to find time to read research?!?
SLPs: How to make sure you're using EBP
SLPs: How to get access to full journal articles