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How Do I start?

    Everyone begins the journey towards cultural competence in a different place.  Those taking early steps may want to do some background reading.  The Early Childhood Research Institute on Culturally and Linguistically Appropriate Services (CLAS) provides resources reviewed by experts.  On their Multicultural Links page, the Multicultural Mental Health Training Program provides more information regarding specific cultural groups.  

    Those more familiar with cultural competency, but in the early stages of program development, may find the following checklist helpful.  It was compiled by the Maternal and Child Health National Center for Cultural Competence.  Following the checklist is an  introductory reading list for cultural competence.


Getting Started:
Planning, Implementing and Evaluating

Culturally Competent Service Delivery Systems for
Children With Special Health Care Needs and Their Families


    Many participants of the Maternal and Child Health National Center for Cultural Competence (MCH-NCCC) train-the-trainer workshop, Culturally Competent Services and Systems: Implications for Children with Special Health Care Needs/ Maternal and Child Health, requested suggestions for getting started within their organizations and programs.  There is no one method to get started on the journey toward cultural competence.  Each organization and individual may embark on this journey at different points of departure with different estimated times of arrival.  Achieving organizational and personal cultural competence is a developmental process.  Most human service organizations and their personnel are at various levels of awareness and stages along the cultural competence continuum.  The following checklist provides some guidance for getting started.

check.gif (864 bytes) Convene a cultural competence committee or task force within your program or organization.  This committee should have representation from policy making, administration, practice/service delivery and consumer levels.  The committee can serve as the primary governing body for planning, implementing and evaluating organizational cultural competence initiatives.
check.gif (864 bytes) Ensure that your organization or program has a mission statement that commits to cultural competence as an integral component of all its activities.   The cultural competence committee should be involved in developing this statement.
check.gif (864 bytes) Network and dialogue with similar organizations and programs that have begun the journey toward developing and implementing culturally competent service delivery systems.  Adapt processes and information that are consistent with your program's needs and interests.
check.gif (864 bytes) Aggressively pursue and utilize resources that are available from federally funded technical assistance centers that have a mandate to catalog information on cultural competence and children’s health.
check.gif (864 bytes) Conduct a comprehensive cultural competence agency self-assessment.  Determine which instrument(s) best matches the needs and interests of your organization or program.  Use the self-assessment results to develop a long-term plan, with measurable goals and objectives, to incorporate culturally competent principles, policies, structures, and practices into all aspects of your organization or program.  This may include, but is not limited to, changes in the following: mission statement, policies, procedures, administration, staffing patterns, service delivery practices and approaches, outreach, telecommunications and information dissemination systems, and professional development activities, etc.
check.gif (864 bytes) Determine the culturally, linguistically, racially and ethnically diverse groups within the geographic locale served by your organization or program.   Assess the degree to which these groups are accessing services and the level of satisfaction with services received.
check.gif (864 bytes) Conduct an assessment of what organization and program personnel perceive as their staff development needs related to the provision of services to culturally, linguistically, racially and ethnically diverse groups.
check.gif (864 bytes) Convene informal brown bag lunches to engage organization or program personnel in discussions and activities that offer an opportunity to explore attitudes, beliefs and values related to cultural diversity and cultural competence.
check.gif (864 bytes) Identify and include budgetary expenditures each fiscal year to facilitate personnel development through their participation in conferences, workshops, and seminars on cultural competence, children with special health care needs, and health care related issues.
check.gif (864 bytes) Gather and organize resource materials related to health care and culturally diverse groups for use by organization and program personnel.
check.gif (864 bytes) Build and utilize a network of natural helpers, community informants and other "experts" who have knowledge of the culturally, linguistically, racially and ethnically diverse groups served by your organization or program.
check.gif (864 bytes) Network with parent and family organizations concerned with children with special health care needs.  Solicit their involvement and input in the design and implementation of service delivery initiatives for culturally, linguistically, racially and ethnically diverse groups.


(Annotated Listing of Monographs from the
MCH-NCCC Resource Bank)


Building Cultural Competence: A Blueprint for Action (1995)
Washington State department of Health, Community & Family Health

An excellent case study of the cultural competence development process in the Community and Family Health Program within the Washington State Department of Health.  It provides specific steps and processes that may be utilized to develop a cultural competency plan and process for an agency.  Includes specific questions and checklists.


Journey Towards Cultural Competency: Lessons Learned (1997)
National Maternal and Child Health Resource Center on Cultural Competency, and
Texas Department of Health

A comprehensive summary of the cultural competence journey of the Texas Department of Health, and a consortium of thirteen states, during development and implementation of cultural competence initiatives for Title V children with special health needs programs funded by the Maternal and Child Health Bureau.  It includes a listing of guiding principles, assumptions and factors to consider when developing culturally competent programs, lessons learned, guidelines and assessment tools, guidelines for interpretation and translation of materials, a bibliography, and a listing of resource personnel.


A Practical Guide for the Assessment of Cultural Competence in
Mental Health Organizations (1996)

The Technical Assistance Center for the Evaluation of Children's Mental Health Systems at
Judge Baker Children's Center

This guide is based on the premise that organizational assessment is a valuable tool-for organizations to become more culturally competent.   It describes how organizations can use the assessment process to examine their current level of organizational cultural competence as well as to monitor their improvement.  It emphasizes practical aspects of implementing cultural competence assessments in mental health organizations.  While this guide targets mental health organizations, there are numerous references that are appropriate for children with special health care needs and health care delivery systems.



This checklist was compiled by:

    Tawara D. Taylor, M.A., Maternal and Child Health National Center for Cultural Competence, Georgetown University Child Development Center, August, 1997.



Introductory Cultural Competence Reading List



     Comas-Diaz, L. & Griffith, E. (Eds.). (1988). Clinical guidelines in cross-cultural mental health.  New York: John Wiley & Sons.

     Eliades, D. C., & Suitor, C. W. (1994). Celebrating Diversity Approaching Families Through Their Food. Arlington, VA: National Center for Education in Maternal and Child Health.

    Gibbs, J. T., & Huang, L. N. (1997). Children of color: Psychological interventions with culturally diverse youth. San Francisco, CA: Jossey Bass.

    Green, J. & Leigh, J. (Eds.). (1982). Cultural awareness in the human services. New Jersey: Prentice Hall.

    Lefley, H. & Pederson, P. (1986). Cross cultural training  for mental health professionals. Il: Charles C. Thomas.

    McGoldrick, M., Pearce, J., & Giordano, J. (Eds.). (1983). Ethnicity and family therapy. New York: The Guilford Press.

    Pinderhughes, E. (1989). Understanding race, ethnicity & power. New York: The Free Press.

    Powell, G., Morales, A., Romero, A., & Yamamoto, J. (Eds.). The psychosocial development of minority children. New York: Brunner/Mazel.



    Bass, B., Wyatt, G., & Powell, G. (Eds.). (1982). The afro-american family: assessment, treatment, and research issues. New York: Grune and Stratton.

    Coner-Edwards, A., & Spurlock, J. (1988). Black families in crises: the middle class. New York: Brunnel/Mazel.

    Jones, R. (Ed.). Black adult development and aging. Berkley: Cobb and Henry.



    Ho, D., Spinks, J., &  Siu-Hing Yeung, C. (Eds.). (1989). Chinese patterns of behavior: A sourcebook of psychological and psychiatric studies. New York: Praeger.

    Kitano, H. & Daniels, R. (1988). Asian-Americans: Emerging Minorities. New Jersey: Prentice Hall.

    Morishima, J. K., Sue, S., Teng, L. N., Zane, N. W. S., & Cram, J. R. (1979) Handbook of Asian-American/Pacific Islander Mental Health. Rockville, MD: National Institutes of Mental Health.



    Becera, M., Escobar, K., & Escobar, J. (Eds.). (1982). Mental health and hispanic americans: clinical perspectives. New York: Grune & Stratton.

    Rogler, L., Malagdy, R., Costantino, G., & Blumenthal, R. (1987). What do culturally sensitive mental services mean? The case of hispanics. American Psychologist, 42 (6) 565-570.

    Abad, V., Ramos, J., & Boyce, E. (1974). A model for delivery of mental health services to spanish speaking minorities. American Journal of Orthopsychiatry, 44 (4), 584-595.



    Blanchard, E., & Unger, S. (1977). Destruction of american-indian families. Social Casework, 58 (5), 312-314.

    Red Horse, J., Shattuck, A., & Hoffman, F. (Eds.). (1981). The american indian family: Strengths and stresses. Isleta, NM: American Indian Social Research and Development Associates.

    Trimble, J. E., Manson, S., Dinges, N., & Medicine, B. (1984). American indian concepts of mental health. In P. pederson, N. Sartorius, & A. Marsala, (Eds.).  Mental Health Services: The cross cultural context. (pp.199-220) Beverly Hills, CA: Sage.

    Joe, J. R., & Miller, D. (1987). American indian cultural perspectives on disability. Tucson: University of Arizona, Native American Research and Training Center.


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