"As a white person living in America, I've never hesitated to seek help from a hospital."
Clinicians hold powerful positions that require them to meet the unique cultural needs of the individuals they serve to provide the best treatment. As a Caucasian female heavily influenced by mainstream white American culture, my experiences are uniquely different from other individuals. I must carefully consider my background and issues of race and ethnicity while serving diverse multicultural individuals.
Several years ago, I began providing in-home ABA therapy to a child whose parents immigrated from the Middle East and followed Islam. I was not familiar with their cultural values and was concerned that my good intentions guided by my cultural influences could be misinterpreted and potentially damage treatment outcomes. I asked questions, observed, and researched to increase cultural awareness and guide my behavior. Over time, I developed a strong rapport with the client and family. I observed hard-working individuals that demonstrated devoted love and care for one another.
The child receiving ABA therapy engaged in self-injurious behaviors. Prior to therapy, he was taken to the hospital to treat self-inflicted injuries. The mother revealed that she was terrified her child would be taken from her if he ever returned to the hospital with similar injuries. She described the experience and the account provoked significant personal reflection. As a white person living in America, I have never hesitated to seek help from a hospital.
Our society is founded on the presumption of innocence until proven guilty, however nonwhite individuals do not always receive this treatment. I asked how I could help reduce these concerns and began to carefully document each occurrence of self-injurious behavior. The family could provide the documentation to the hospital should the need arise.
"We must continually expose ourselves to the different cultures of the individuals we treat and have conversations about diversity."
I began to develop more concerns regarding other clinicians’ behaviors that reflected a lack of cultural awareness and its negative impact. For example, during monthly in-home visits, a Caucasian social worker refused to remove his outdoor shoes upon entering the household and commented after female family members refused to shake his hand. After I privately explained to him these actions are considered rude in their culture, he mentioned that he understood the importance of race and ethnicity. He did not change his behavior, and eventually, family members stopped seeking his assistance.
Failure to include cultural awareness in practice negatively impacted his relationship with the family and treatment outcomes. We must continually expose ourselves to the different cultures of the individuals we treat and have conversations about diversity. This can develop a stronger understanding of client and family perspectives. Each individual we serve can guide our process of cultural awareness to reduce bias and achieve the best treatment outcomes possible.
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