Culture / Occupational Therapy

The Myth of Cultural Competence

In OT school, we often discussed the idea of becoming culturally competent so we are better able to serve the ever-growing/changing culturally diverse needs of our clientele. This idea of cultural competence is based on cultural awareness – that we are first aware of our own culture/biases, and secondly aware of  and sensitive to cultural differences. Perhaps this is all just semantics, but competence to me means doing something proficiently, beyond just awareness. Competence is having a skill set, or expertise, to complete something successfully. But even the most culturally-aware, open-minded individuals can encounter a cultural faux pas occasionally, no? With the sheer existence of so many varying cultures out there, is it even possible to really ever be fully, 100% culturally competent? Though cultural competence can be thought of as more of a process, than just a skill set you have or you don’t, I think there is a better term for it.

I heard a seminar at AOTA about an alternative way to look at this dilemma. It’s the idea of cultural fluidity. Under this purview, one does not deem oneself “competent” per se, but rather as part of a dynamic and reflective process of understanding, using transformative learning. In this way, for each new cultural situation we posit our assumptions against the other person’s assumptions as part of our dilemma to come to a transformed perspective. In this seminar, the presenters talked about their experiences in Ghana and China as OTs or OT students. Some of the things they saw initially made them think the locals were not doing enough. But once they talked to the locals more, they found out that their assumptions were not valid in these contexts and that there was more to what they saw. For example, in Ghana pushing the idea of independence for oneself didn’t translate well because they viewed independence as a way to help others, not themselves.

I like the term cultural fluidity as it mirrors the dynamic cultural landscapes in which we live and work in today’s world. Furthermore, culture itself is a dynamic, ever-evolving entity. No one culture will always stay the same over time. To me, semantically, this term also allows us to be sometimes culturally incompetent….and to be ok with that. It’s ok to admit that we don’t know what to do or what to think when faced with a new or different cultural dilemma. This term gives us that freedom to be less competent, cause hey, we can’t all be experts in every culture of the world! But it gives us a process for reflection and developing better understanding.

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