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Cultural competence (also called cultural competency) is an educational field of practice that has gained currency over the past 2 decades within medicine, psychiatry, nursing, social work, public health, counseling, and other allied health professions. First introduced during the 1980s, cultural competence serves as an umbrella term and refers to an integrated knowledge base and skill set which enables professionals to work respectfully that effectively with individuals, families, and communities from diverse cultural and linguistic backgrounds. Cultural competence extends to institutional and organizational policies and practices that support the reduction of health and mental health disparities through improving patient–provider communication, workforce diversity, and community engagement. This entry reviews key components of cultural competence as they relate to practitioners and institutions/ organizations, describes some of the field's resources, and discusses the strengths and limitations of the concept and field as it continues to evolve.

Key Concepts and Components

With conceptual origins in the civil rights movement, cultural competence combines goals of social justice and equity with the efficient delivery of health and mental health care. Working with the assumption that culture (defined as shared values, beliefs, and patterns of behavior) is a dynamic force that shapes the ways individuals and populations engage service delivery systems, proponents of cultural competence argue that the elimination of cultural and linguistic barriers in the provision of health and mental health services will reduce disparities and improve outcomes for historically underserved populations. Cultural competence initiatives often focus on the education and professional development of practitioners by raising awareness of the self and other, building knowledge of culture and the ways it informs behavior (of patient and provider); and developing and enhancing skills for effective practice with diverse populations. Special attention is given to the role of language and cross-cultural communication across varied groups. Cultural competence initiatives may also address issues of accessibility for differently abled individuals as well as seek to create safe and affirming spaces for gay, lesbian, transgender, questioning, and intersex individuals.

Towards a Culturally Competent System of Care, Volume 1, published in 1989 by a working group that included Terry Cross and her colleagues from Georgetown University, was the first work to expand cultural competence beyond the practitioner level and argue that a system's capacity to incorporate the values and principles of cultural competence into structures and policies that support desirable practices and measure outcomes is a key component of the emerging field.

Professional Resources

During the past 2 decades, a number of government agencies and professional associations have adopted cultural standards and principles for culturally and linguistically competent practice and have sought to consolidate an evidence base and measures for continual improvement and equity. The National Center for Cultural Competence (NCCC) at Georgetown University provides a comprehensive set of resources with the goal of increasing the capacity of health and mental health care providers to deliver culturally competent services through knowledge development and training of practitioners as well as influencing policy at the national and local levels. NCCC places emphasis on translating research into policy and practice and provides training, technical assistance, and tools for implementation by practitioners.

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