You're Doing It Wrong: The evolution of cultural competence | Raquel Martin | TEDxRutgersCamden

last week I walked out of a training from my colleagues feeling a sense of exhaustion and frustration and this is not the first time I have felt this way when I leave these trainings I typically feel like they have doubled down on stereotypes rather than providing me with ways to address my biases and practice anti-racism cultural competency and diversity trainings are so prevalent these days and they should be as we venture to a space of acknowledging addressing and understanding the impact that power Prejudice and privilege has on this world and all those that reside in it however the truth is typically when I attend these trainings I find them to be a waste of my time and that is heartbreaking to me because we are worse off due to these poor trainings that do not provide us with ways to improve The Human Experience I take personal offense to these lackluster trainings because in the many roles that I hold I see the impact that subpar cultural understanding limited cultural humility and outdated cultural knowledge has on the world I see the impact as a professor when my students come to me and share that once again they have been Val invalidated and the victims of racism by my colleagues in Academia I see the impact as a scientist when I look at statistic after statistic regarding the number of black patients and patients of the global majority that feel seen when they visit their doctors these patients are significantly more likely to be misdiagnosed because the biases that their doctors hold impact their ability to do an appropriate assessment and do their job I see the impact as a licensed clinical psychologist when I work with patient after patient after patient regarding ways to deal with the impact of Oppression that they experience in the workplace in their neighborhoods and sometimes in their own families and I see the impact as a black woman in America who often has to convince others that I am not a threat simply because of the color of my skin or the fact that my hair defies gravity I see the impact every day you know so many people attempt to teach about cultural competence and the role of cultural competence without understanding the history behind the term did you know that when professor in psychologist Dr Daryl Wing Sue coined the phrase cultural competence he stated that it is not possible to be fully versed on a group of people in your lifetime it's true he actually stated that it is more important to have experiential learning to engage with people that don't look like you who from different walks of life as human beings than it is to focus on the academic trainings the cognitive understanding that so many of these diversity trainings seek to embody but that's not really how we're taught cultural competence is it every year we are mandated to go to at least one mandatory training most of the time it is in February we all know why it is typically in February and then we see a speaker we watch a webinar we check off a box we get the certificate and too often the education ends there no afterthought no follow-up no experiential learning and that was never how it was meant to be when we treat cultural competence like an achievable goal like a Finish Line to be crossed we completely missed the mark and we do Injustice to all those that will be significantly impacted by our ignorance by our insensitivity and by our inconsideration I unfortunately have witnessed many incidents of poor cultural competence but one that always sticks with me was during a panel a planning session between licensed clinical psychologists the purpose of the session was to identify ways to teach distress tolerance to a group of black youths we typically do this by stimulating some form of stress that is deemed reasonable and then allowing the children to practice their coping skills in a safe environment this is typically done by showing a scary movie clip but this year a psychologist proposed that they changed the scene to a scene from the movie Crash which depicted beliefs police brutality the offenders were European American police officers and the victims were a black couple I want you to think of how abominable a decision it was for licensed mental health professionals whose job it is to contribute to the mental healing of youths to decide that showing of seeing that depicted police brutality would create what is deemed as a reasonable amount of distress and black youths I often wonder what contributes to these poor decision making especially among licensed mental health professionals I believe it happens because the way we seek to understand and learn more about individuals from diverse backgrounds and cultures is limited to zoom meetings and workshops and webinars I want to share some data with you so I can fully help you understand and humanize the experience of what poor cultural confidence contributes to black boys and girls are respectively three and six times more likely to be suspended from school then their European American peers for displaying the same behaviors in 2003 The Institute of medicine published a 700 page document entitled unequal treatment this revealed that black patients have a higher mortality rate when it comes to heart disease cancer and HIV and AIDS than any other U.S racial or ethnic group and this disparity is not due to differences in access to care in fact at equivalent levels of access to care Black and Hispanic patients are significantly less likely to receive gold standard treatments that are known to treat medical disorders including heart attacks there's even disparity in the effectiveness level of medical apparati pulse oximeters are used every single day and hospitals to measure the level of oxygen in the blood they are used with disorders such as pneumonia lung cancer and asthma however a study in 2022 revealed that they are less effective in individuals with dark skin pigmentation like black patients the inability to appropriately measure the level of oxygen in the blood can contribute to a number of medical difficulties and possibly death a study of over 4 700 participants revealed that black patients are more likely to be subjected to dominant communication styles from their doctors less likely to be provided with all the treatment options and less likely to be engaged in participatory decision making for their own Medical Care and if we go back to the development of the field of medicine we will come across J Marion Sims a man who is lionized as the father of modern gynecology and who perfected his technique by operating on enslaved African women without anesthesia and certainly without their consent I often see these things therapeutic care as well I want to put you in the driver's seat so you can understand how this can manifest in the therapeutic process a patient comes to your office a black woman comes in and she is seeking mental health care after you do an assessment you identify the fact that she is having difficulty identifying her strengths and abilities she often feels like a fraud in her environment and she is having such difficulty meeting her goals so you collaborate together to identify a plan you decide to start with assertiveness training it is an effective treatment when it comes to anxiety and stress but it doesn't work during the next appointment she shares that she is having difficulty identifying any positives in her life when she thinks about goals when she thinks about what she can achieve she can't identify one so you propose the use of a gratitude Journal but it doesn't work during the next session you do more digging and she shares that she has never experienced this form of feeling like an imposter before typically she thrives in all her environments and that is when you decide to empower her you share that she simply needs to be authentic in her space and people will welcome her obvious intellect in her vivacious personality and that is where you lost her she goes you and she does not come back for another session now as the clinician in the room you do what anyone does when they are ghosted personally or professionally you ask yourself why what happened you walk yourself through the steps you utilize patient-centered care because your training taught you that so often black patients aren't even engaged in treatment options they're just given to them you empowered her and used a strength-based perspective because you learned in your training so often black patients are treated from a framework of deficits which is also harmful you did everything that you were taught to do but what you missed is what wasn't included in the training and what so often is not included in the trainings because they seem to make others uncomfortable and that is the fact that when your skin is weaponized everything is a privilege authenticity is a privilege because everything can be perceived as a threat from the tone of your voice to the way that you wear your hair did you know that black women were one and a half times more likely to know someone who was sent home for their hairstyle or to be sent home for their hairstyle and this isn't limited to the workplace hair discrimination has been found in youths as young as five years old they're creating a respectful and open world for natural hair is a piece of legislation that was created by four phenomenal women who felt that black individuals should not be held back and discriminated against in the workplace and in school because of the way that they wore their hair however not even 50 percent of states in the United States have enacted this piece of legislation in fact although it passed the house in March 2022 it was blocked in the senate in December in 2022. I want you to think about that for a second how many times when you think of privileges do you think about authenticity when you take a step to ruminate on that I want you to ask yourself has legislation ever had to be passed so that you were not retaliated against for the way that you wore your hair the way that it came out of your head what's more authentic than that that stress that anxiety that your patient felt could likely have been a result of stereotype threat this is a form of Stress and Anxiety that presents itself when you have a fear of conforming to a stereotype that is attributed to your group now there are many egregious stereotypes when it comes to black people but a very common One deals with the lack of intellect if I am working and stereotype threat presents itself and it often does I will create so much mental energy combating that stereotype I'm not stupid I'm smart I can do this let me check triple check and double check that I won't even divert the right amount of energy to perform the task that is well within my ability to do which will contribute to significantly more mistakes everyone has stress when it comes to performing tasks but stereotype threat gets in the way of you doing things that you can even have the ability to do overall when you think about the integration of all the symptoms and what contributes to racism related stress and and difficulties within the environment I want you to think about a tree that stress that hesitance that fear that imposter syndrome that your patient was experiencing that was a branch but the things that are contributing to those the maintenance of those branches thriving and whistling in the wind every day is racism those are the roots if we ever want to improve The Human Experience of individuals overall through all of these trainings they must address the roots when you walk out of a training with the same way of thinking the same information that you walked into the training with the problem is the training we need to vary the forms of information that we Herald so many times we focus on peer-reviewed journals and those are a good start but publication bias also exists it is easier for a research study that focuses on European Americans to be published and one that focuses solely on black people or black people or people of the global majority and not in comparison one that focuses solely on these individuals and the intricacies of the experience in the diaspora we also need to look at the way we do these trainings are we looking at intersecting identities age ability level sexual orientation it seems like a lot to include in one training and it is and the goal is not to include it in one training the whole purpose of this is to be an experience and understanding that it is a journey when it comes to cultural competence we need to focus on engagement a three-hour talk with 15 minutes of q a is not enough time you need to look at books and break them down you need to listen to podcasts and break it down we need to really vary the information that we share the narratives that are experienced and the way that people choose to share them and have a conversation do you have difficulties having the conversation are you uncomfortable let's start there where is the discomfort coming from are you afraid of being wrong that's okay I would trust someone who admits to being wrong way before I trust someone who says that they're right all the time are you feeling oppressed in the environment that the the training is happening let's start there what form of Oppression are you experiencing is it internalized is it institutional is it cultural all of these have different treatment plants but they can all be accomplished we need to come back with tangible goals and metrics for achieving those goals it's not enough to say that we want the environment to be less oppressive we need to say that we are going to look at our policies and come back in two months and three months yes your policy May state that it is against discrimination when it comes to skin color but what about hair what about hairstyles or hair lengths or protective styles that are attributed to certain individuals of racial or ethnic Origins how diverse is your company is your organization really when you go up different levels of the hierarchy do you notice that individuals start to look the same that's not diversity and it's just important to look at these things from day to day it didn't take one day to build that bias it's not going to take one day or what training to break it down there is no such thing as being colorblind when you say you don't see my color you don't see me and it also places emphasis on the wrong thing color is not the issue race is not the issue racism is when we focus on what is really important we can work towards improving The Human Experience overall and the many roles that I hold scientists psychologists person Professor I'm here to tell you therapy is not going to fix it all my office should not be the only safe space that someone holds I should not have to manage the fear of individuals who took a Hippocratic oath to protect me those who decided to Serve and Protect others the world should feel like a safe space and if we are going to address that we have to look at the roots we have to be okay with being wrong and we have to improve The Human Experience overall by understanding my cultural competence is not a Finish Line we're going to work on this our whole lives thank you

Channel: TEDx Talks

Views: 44,255

Keywords: Compassion, Culture, Empathy, English, Global Issues, Health, Race, Racism, TEDxTalks, [TEDxEID:51703]

Id: FNCu1ED0Zsk

Length: 17min 15sec (1035 seconds)

Published: Thu Feb 16 2023