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Alaskan Cross-Culture: Native Behavioral Health
First, multiculturalism is an intensely held belief Beliefs are important as ethical principles but they can be problematic when expressed as "truths" or facts. For example, "integrity" is an important principle in social work practice and its absence in social work interventions would suggest malpractice. However, it should not be defined as something that a social worker should "know." Integrity is an ethical virtue (MacIntyre, 1984) and it represents a belief about how practice should be conducted. The 1999 NASW Code of Ethics correctly represents integrity as a value that permeates all aspects of practice. Integrity, for all its importance, cannot be demonstrated as testable knowledge. It is believed to be important, but it cannot be represented as fact.
Scientifically developed ideas rise and fall based upon their ability to withstand independent criticism, continuing research, and application. Beliefs, on the other hand, owe much of their genesis and sustained value to feeling and emotion (Zagzebski, 1996). The ideological quality that often surrounds multiculturalism suggests that it is more allied with belief than science. Likewise, the emotional intensity that is often associated with the idea should indicate its centrality to social work values rather than to objective knowledge or identifiable skills. Plato made the distinction between beliefs and knowledge in the dialogue Theaetetus by defining knowledge as being able to give accounts through technical information, while beliefs may or may not reach this threshold of facts (Plato, 1961). For example, psychoanalytic views of the etiology and treatment of schizophrenia were once widely endorsed but have since been found to be not only wrong and unhelpful, but potentially even harmful (Torrey, 1995). Beliefs about double-bind communication and the "schizophrenic" mother (Arieti, 1974) have not been validated by research on schizophrenia (Torrey, 1995). As these examples suggest, the difference between factually supported knowledge and beliefs can be obscured when the beliefs are widely endorsed. The level of endorsement, however, does not make them more true or accurate accounts of reality.
Belief in the importance of cultural influence should guide all social work practice and educational areas--clinical, administrative, research, and community organization. This is why multiculturalism is a guiding value about how to approach and work with people rather than a specific knowledge area. However, the ethical effectiveness of the principle might be diminished by representing it as a knowledge area that can be tested for competence. Reification of beliefs is germinal to dogmatism and the conversion of a value or guiding principle into an "objective" content area runs the same risk. A belief, when defined as a fact, is beyond critical challenge. By trying to make multiculturalism an uncontested knowledge area, its potency as a value statement might be compromised by the dogmatism attached to the idea. Ironically, the treatment of multiculturalism as an imperative construct brings it close to what some have called moral fundamentalism, a concept typically opposed by multiculturalists (Baker, 1998). When social workers dispute the factuality or specificity of multiculturalism, they risk diluting the importance of the idea as a guiding ethical premise for all social work practices. Furthermore, an idea that lacks intellectual integrity but has a high degree of dogmatic endorsement can create dissonance for practitioners.
The second argument against the representation of multiculturalism as a specific content area focuses on the dangers of stereotyping. Human cultures are extremely varied and extraordinarily complex (Sue, Zane, & Young, 1994). Furthermore, the intersection of cultures with economic factors, political environments, religious variation and individual and family differences make any generalizations about them prone to unintended stereotyping. This risk may be compounded by the ethics standard that makes knowledge of clients' culture an imperative. The unfortunate result of the ethic might be the very opposite of what is ethical: stereotyping due to misgeneralization or over generalization. Even when well intentioned, statements of "knowledge" about another person's culture carry an inherent risk of misrepresentation or even stereotyping.
Ethnicity, which is often incorporated in the literature on cultural diversity and multiculturalism, is equally difficult, if not impossible to objectively measure, and it actually cannot be "tested" empirically (Kato, 1996). Ethnicity, like culture, intersects with many other factors, including class, social roles, region, and the current and historical political context. Cultures are not static, nor is cultural identification a constant, since people change their identifications along with other changes in circumstance or condition (Trimble, 1996). Also, people act upon their cultures-it is not just a one way street (Modell, 1996). Some have tried to describe approaches with different cultural groups based on generalizations about them (McGoldrick, Pearce, & Giordano, 1982). It is unclear, however, whether this literature has captured all the salient subcultures in the United States, or whether these cultures, described over a decade ago, still conform to the patterns defined at that time. While some point out that ethnic consciousness can span generations (McGoldrick, Preto, Hines, & Lee, 1991), culturalism is "knowledge" that can spoil with time and can suffer substantial distortion from one neighboring region to another--even among people in the "same" culture (Hermans & Kempen, 1998). Consider a Bostonian social worker describing "Appalachian" culture, when those who live in Appalachia sense dramatic differences from county to county and even within the area of a county. Aponte (1995) inadvertently demonstrates the potential for stereotyping by lumping "rural" peoples with Appalachians and stating that Appalachians are easy for whites to identify with because they are white. Appalachian culture, however, has been marginalized by "white America," and even the use of the term "Appalachian" borders on stereotyping, as it assumes a homogeneity throughout the region (Billings, Pudup, & Waller, 1995).
Arguing for multiculturalism as a measurable body of knowledge leads to the problem of testing the social worker for cultural competence. The complexity of culture creates a virtual Scylla and Charybdis for testing of cultural competence in the licensing process. On the one side, the sheer complexity and diversity of cultures makes it difficult to create meaningful test content. On the other hand, stepping back from complexity and specificity leads directly to stereotyping by overgeneralization and simplification. It is almost impossible to avoid stereotyping in constructing basic written test items pertaining to culture.
Virtually every article on multiculturalism makes some concession to the problem of stereotyping by addressing the need to identify both the differences and the similarities of various cultures (Glugoski, Reisch, & Rivera, 1994) but this is a difficult problem to resolve solely by cautionary advice. Cultural competence has been measured as "a set of academic and interpersonal skills that allow individuals to increase their understanding and appreciation of cultural differences and similarities within, among, and between groups" (Woll, 1996). However, reminders to be sensitive to the balance between difference and similarity does not prevent stereotyping.
Reflection Exercise #2
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