Culture and Diversity Lunch & Learn Webinar March 19, 2015 11:30am-12:30pm KIPBS KDADS
Learning Objectives 1. Build awareness of diversity and the continuum of cultural competency. 2. Identify the relevancy of learning about culture and diversity 3. Understand the impact of language when working with clients 4. Identify ways to build cultural competency and/or implement culturally sensitive practices.
3 What are happiness, helpfulness, and hopefulness as they pertain to PBS? Collectively, they represent an empirically driven concern with QOL, with support through systems change, and with linkage to multiple behavioral, social, and biomedical sciences. JPBI Winter 2007 Edward G. Carr,
4 This is the expanding vision of PBS, a vision that impels us to create meaningful lives and not simply to eliminate psychopathology, a vision that spurs us to change systems and not just people, a vision that motivates us to seek collaborative possibilities with our colleagues in many different sciences so that we can transcend our superficial differences and focus on deeper commonalities. It is a vision that holds promise for each one of us so that at the end of our lives we can say, I made a difference. Edward G. Carr, JPBI Winter 2007
5 Kids that fall between the cracks Undiagnosed Add image here Multiple Diagnoses Isolated area may lack screening and services Multiple transitions
6 Kansas Stakeholders & Support Systems Frail and Elderly Developmental Disability Technical Assistance Traumatic Brain Injury Physical Disability Seriously Emotionally Disturbed Autism
7 Transitions To and From Home Into Adulthood Within a System From One System to Another
8 Mental Health I/DD Child Welfare Juvenile Justice
Judgement Negative System Interaction Crisis Distrust Isolation
Judgement Negative System Interaction Crisis Distrust We have to Disrupt the CYCLE by Considering Trauma Culture Diversity Family Cycle Isolation NO ASSUMPTIONS
BUT related to barriers created by Different Types of Diversity: Racial Physical appearance Ethnic Origin or ancestry Cultural Shared set of knowledge, beliefs and behaviors that is transmitted to future generations. Socio-Economic Interaction of social and economic factors. Disability Physical, Mental, Emotional
12.4% of Kansans Live in Poverty (2010 American Community Survey Data for Kansas) Stop and Think: 1. Can improved economic health improve mental health? 2. Can improved mental health improve economic health?
The Culture of Poverty? (Caution) A social theory used to explain the cycle of poverty. Previously implied that an individual s inherent characteristics, such as their values and behaviors, were to blame for poverty. More recently used to describe characteristics exacerbated by social and economic barriers (such as racism and isolation) to explain poverty.
Three Largest Race/Ethnic Groups in Kansas: (2010 American Community Survey Data for Kansas) 1. White - 78.2% 2. Hispanic - 10.5% 3. Black - 5.7% http://www.kansas-demographics.com/
Dynamics of Culture The cultural environment of an individual has a significant effect on the skills they develop and how they process: Mental conceptualization Physical experience, concrete Spiritual observation, reflective Social and Emotional experimentation, active
Cultural Awareness Personal space Concepts of time Family and kinship Work and recreation Nonverbal cues Topics and patterns of conversation Perceptions of problem behavior Value systems Political histories Sexual identity
Cultural Competency Self-Awareness of one s own culturally based behaviors, values, habits and beliefs. Knowledge of information specific to each culture. Skills that enable an individual to engage in successful interactions.
Build Cultural Awareness Describe a time you worked with a client with a culture different from yours. How did that impact your ability to work with that client? http://ctb.ku.edu
Continuum of Cultural Competency Cultural Pre- Competence Cultural Competenc e Cultural Proficienc y Cultural Blindness Cultural Incapacity Cultural Destructiveness SAMHSA
Build Cultural Knowledge 1. Establish friendships with people from other cultures. 2. Put yourself in situations where you will meet people of other cultures; especially if you haven t had the experience of being a minority. 3. Ask people questions about their cultures, customs, and views. 4. Read about other people s cultures and histories. Are there other ways you can think of? http://ctb.ku.edu
Build Cross-Cultural Skills 1. Practice being aware of differences without placing judgment. 2. Practice listening without judging. 3. Ask yourself how your personal differences impact the goal of your work. 4. Imagine yourself growing up with the experiences of the person you are working with. 5. Practice cultural etiquette. Are there other ways you can think of?
Understand the Impact of Language Formal versus informal Language discrimination Use of children and family friends to interpret Ethical considerations Power of communication
Language Discussion 1. Have you even tried to learn another language? 2. Have you ever been uncomfortable around others speaking another language? 3. What if you couldn t communicate your thoughts, feelings and questions? 4. How would it change things if your children had to communicate for you?
Tips for When a Language Barrier Exists 1. Avoid using academic language. 2. Avoid using jargon. 3. Check often for understanding. 4. Ask the client or parent to explain their understanding in their own words. 5. Make sure the client or parent has an opportunity to provide input before moving on. 6. Read nonverbal cues.
Cultural & Diversity Considerations When Conducting an FBA and Developing a Support Plan 1. Acknowledge the cultural make-up of your team and address any need for cultural awareness, diversity related skill set, knowledge and/or skills. 2. Is the planning process sensitive to the cultural values and diverse needs of the client and family? 3. How can the behavior be interpreted through a different cultural lens?
Evaluate the Plan For Goodness of Fit Ensure the plan reflects the values, skills and resources of team members: Contextual Fit Survey Team Satisfaction Survey Quality of Life Survey Other considerations?
Disability and Mental Health Specific Considerations
Youth and Family
29 Biological Setting Events Pain due to: Media Overexposure Headaches Gastro esophageal Reflux Disease or other GI problems Menstrual Pain Illness (chronic conditions or acute illness) Sleep Deprivation Mood Allergies Fatigue Hunger
30 Mental Health Related Setting Events Trauma background Sensory: Sight, smell, or sound related to a person or place Power Differential Unpredictability: Changes in routine outside of person s control
31 Mental Health Related Setting Events Diagnosis Specific Depression: Lethargy, inability to concentrate, slow to respond Anxiety: Feeling overwhelmed even by small tasks, somatic responses Disruptive Disorders: difficulty sitting still; high energy All of these may cause a person to react in an emotional manner to a seemingly insignificant trigger.
32 Mental Health Related Setting events Psychotropic Medications Substance Use/Abuse Influence of peer group/particular peers
33 Genetic Factors Behavioral phenotype associated with a genetic disorder can impact behavior plan on many levels: Certain reinforcers are more or less effective More predisposed to certain behaviors and response patterns Also impacts types of interventions chosen
34 Identifying Mental Health Issues in Individuals with ID Historically ignored in people with severe ID Now getting better at looking at behavioral symptoms, but primarily rely on caregiver Several rating scales being developed to assist in diagnosis Still some individuals with IDD have difficulty accessing MH services
35 Identifying possible I/DD in individuals with MH issues. Perseverative Interests Lack of social skills Slow progress in traditional talk therapy Difficulty generalizing skills learned Rigidity Sensory Issues Known or Suspected Learning Disabilities
36 Mental Health Consideration How do you separate behavior that is motivated by environmental factors versus behavior affected by mental illness (or an interaction between the two)?
37 Mental Health & IDD Considerations Collaborating with team is more complex May have to refer to other specialists (counselors, psychiatrists, social workers) Wider circle of support
Discussion