Last year the Standards of Practice Committee reflected on existing College resources with respect to the issue of cultural humility, which is defined as — and suggests — a lifelong commitment to self-reflection and redressing of power imbalances. The Committee wished to determine whether the current College resources are sufficient to address this issue in order to assist members in ensuring that they provide services in a sound and ethical way. After a consultation process, the Committee considered the information and made recommendations for next steps.
The consultation process involved four steps:
- Reviewing the Code of Ethics and Standards of Practice Handbook and the experience of the College’s Complaints and Discipline Department for relevance to cultural humility.
- Conducting a review of other Canadian social work regulators’ resources on cultural humility.
- Conducting an environmental scan of Ontario regulators’ resources on cultural humility.
- Gathering information from identified stakeholders including the Association of Social Work Boards (ASWB), the College Council, the Ontario Association of Social Workers (OASW), the Ontario Social Service Workers Association (OSSWA), the deans and directors of Ontario social work programs and coordinators of social service work programs, and a selection of College members who represent different areas of practice, experience and geographical settings.
As a first step in the consultation process, the Standards of Practice were reviewed for their applicability to cultural humility. The Standards of Practice apply to the breadth and scope of social work and social service work practice. They are written to be broad so that they are applicable to the variety of client groups and practice settings in which members practise, as well as to direct, indirect, clinical and non-clinical practice. The Principles and Interpretations contained within the Standards of Practice prescribe the basis on which professional practice is conducted in a sound and ethical manner. The following are relevant to the definition and intention of cultural humility as they speak to factors that underlie oppression and marginalization:
Principle II: Competence and Integrity, Interpretation 2.2.9 states that “College members promote social justice and advocate for social change on behalf of their clients. College members are knowledgeable and sensitive to cultural and ethnic diversity and to forms of social injustice such as poverty, discrimination and imbalances of power that exist in the culture and that affect clients. College members strive to enhance the capacity of clients to address their own needs. College members assist clients to access necessary information, services and resources wherever possible. College members promote and facilitate client participation in decision making.”
Principle III: Responsibility to Clients, Interpretation 3.4 states that “College members do not discriminate against anyone based on race, ethnicity, language, religion, marital status, gender, sexual orientation, age, disability, economic status, political affiliation or national origin.”
The College’s Complaints and Discipline Department estimated that concerns pertaining to cultural humility have been identified by clients in less than one per cent of all complaints. In these instances, cultural humility was never the sole allegation and was not identified at the outset of the complaint but rather came up throughout the course of the investigation.
Phase two of the process included a review of Canadian social work regulators’ resources on cultural humility. Two provinces have practice guidelines that explore working with Indigenous populations and within a cultural competence framework, respectively. Three provinces have a specific cultural diversity standard within their standards of practice. Five regulators, including Ontario, identified that the theme of cultural humility was embedded in their standards of practice.
The third step of the consultation involved an environmental scan of Ontario regulators’ resources on cultural humility. Twenty-three health and non-health regulatory colleges were contacted. Seven regulators provided a response, however, only three noted that they have a practice guideline or resource that focuses on members/registrants’ knowledge of culture and its impact on service delivery and/or recognizing that clients come from diverse backgrounds, with their own histories which have informed their experiences.
Step four involved gathering information from identified stakeholders. The ASWB has several cultural competence resources on their website, to serve as ongoing educational supports to their members. In the ASWB Regulatory Brief, research was conducted to explore how cultural competence is addressed in social work regulations. The ASWB reviewed information from 62 jurisdictions, including the 10 Canadian provinces, 50 U.S. states, the District of Columbia and the U.S. Virgin Islands. The ASWB found that 30 jurisdictions addressed cultural competence in one or more areas of their regulatory framework. The research showed that cultural competence was addressed primarily in practice guidelines, continuing education or the standards of practice.
Finally, a survey was sent to 100 stakeholders, and 35 responses were received. It should be noted that a response rate over 30 per cent is widely considered to be significant. The survey was sent to all members of Council, staff at the OASW and the OSSWA, the deans and directors of Ontario social work and social service work programs, as well as a selection of College members who represent different areas of practice, levels of experience and geographical settings.
Participants were asked two questions:
- Have there been any dilemmas or recurring themes that have emerged for you while working within a culturally diverse context?
- Were there resources that were helpful to you in doing this work?
In regard to the first question, responses were analyzed in terms of their applicability to, and any potential gaps within, the Standards of Practice. It was determined that all of the dilemmas identified by stakeholders were addressed by interpretations within the Standards of Practice. There were several themes that emerged from the identified dilemmas. Respondents revealed that when working with clients whose culture was different than their own, further understanding was needed with respect to:
- How political context shapes lived reality.
- Differing social norms.
- How mainstream services and policies can fall short in meeting the needs of diverse clients.
In regard to the second question, respondents indicated that the Standards of Practice were helpful when working with clients who have a different cultural background than their own. Consulting with individuals who have different cultural experiences and engaging in self-study prove to be significant factors in building competency in working with diverse client groups. Respondents indicated that ongoing training was helpful in developing competence.
These emergent themes all speak to the requirement for further education and understanding of the historical, political and structural systems that keep oppression in place. This type of education could be included in an ongoing way as part of the College’s Continuing Competence Program (CCP), to aid members in embedding a lens of cultural humility throughout their career.
After considering the information gathered through the consultation, the Standards of Practice Committee concluded that the Standards of Practice are sufficient and effective in working within a culturally diverse context. They also determined that there is a need for members to develop and deepen a commitment to self-reflection, further education and redressing of power imbalances. Members are strongly encouraged to include goals related to working with culturally diverse clients in the Professional Development Plan of their CCP. Applying the Standards of Practice and engaging in further education is consistent with the approach taken by other regulatory bodies who were surveyed.
Consultation respondents provided examples of how they addressed their practice dilemmas and incorporated cultural humility into their practice. As an educational tool, the Practice Note, “Cultural Humility: A Commitment to Lifelong Learning” in this issue of Perspective, explores these issues and provides considerations for practice.
If you have questions about this issue or other practice concerns, please contact the Professional Practice Department at 416-972-9882 or 1-877-828-9380, or email email@example.com.