Why ‘culturally responsive’ practice starts with looking in the mirror.
Kate Morling - Certified Practising Speech Pathologist at Communicate with Kate Speech Therapy
Cultural responsiveness; It’s the latest in buzz words for health professionals. Like so many before it, it's a concept thrown around by many corporations and professionals without truly understanding its meaning, importance and impact for their clients. As speech pathologists, what is it to be ‘culturally responsive’ to our clients, and with so many different clients each with individual cultures, where on Earth do we start? Perhaps we need to start by turning our lens inward…
‘How do you culturally identify?’ I ask my Mexican friend who spent most of his life living in Paris and is now married to an Australian and raising a bi-cultural/multilingual daughter. As you can imagine, his answer is anything but straight forward. It begins with discussion of ‘tacos vs kebabs’ and is summarised by an intensely reflective discussion centred around the impact of colonisation in Australia vs Mexico.
It’s easy to see cultural responsiveness as an examination of ‘them’; the other, the outsider, the client who is here as an expat or an immigrant. But examining our own culture is equally important, if not more so. How can we truly see the other, without first understanding the lens through which we are making our judgements and framing our understanding?
‘How do you identify culturally?’ he asks me back. Having lived abroad for close to 10 years, my immediate response is ‘Australian’. I’m the Aussie. But as I sit with the question longer, so much more comes to the surface to define me. I am a woman, and I share cultural bonds with other women. I’m from coastal Australia, a culture unique unto itself. I’m a mother. I’m an immigrant. I’m a millennial. All these things shape my culture. All these things shape my worldview, my assumptions made about others, my reactions to events, my moral compass, my judgement of how things should be and how others (and myself) should behave.
Engaging in cultural self reflection and dissection can shed light on the cultural biases we all naturally hold, and build a level of self awareness necessary for our practice as speech pathologists working with culturally and linguistically diverse (CLD) families.
My Australian culture arrogantly tells me my punctuality makes me superior; that being on time is a reflection of my education and respect for others. My culture runs on ‘clock-time’; events have a clear start and end point as measured by the number on a clock. Working in Mexico, a culture that typically runs on ‘event-time’, whereby events begin and end based on a response to what is happening and the general flow of an activity, this poses a problem.
My 9am meeting doesn’t start at 9am. It more likely starts at 9.37am once my accountant has finished his morning routine of coffee and checking his emails over pan dulce. My culture leads me to a biased judgement that this is rude, perhaps even disrespectful, and by 9.15am, certianly very irritating. When my 4.30pm client is 20 mins late to their speech therapy session, what judgements will I naturally lean to, and how will this impact my view of and relationship with my client whose culture is simply different to mine? How can I set clear expectations around appointment times and scheduling that respects both their way and my way of doing things?
Once we have turned inwards to better understand the lens through which we see the world, the lens looking outward becomes clearer also. With a deeper understanding of our own culture, we are better able to see the differences of others without our biases clouding our lens (or at least notice the fog!). Armed with this new found view, we can begin to implement true culturally responsive practices.
So how do we bridge the gap? Here’s our Top 3 Cultural Bridging Techniques:
Explaining why: It seems obvious, but explaining why you’re doing what you’re doing doesn’t always come naturally to SLPs. Often, we take for granted that clients will have an understanding of our work as speech therapists but many won’t. Empower families with knowledge and understanding - why do we need you to fill out a Case History Form with your background information? Why is home practice important? Why do we look like we are playing and not ‘getting work done’?
Set expectations, and ask for theirs too!: As SLPs, we are often great at communicating our expectations around payment, homework, consent and therapy goals, but don’t forget to ask your client what their expectations are too. What do they hope to achieve through speech therapy? What do they expect therapy to look like? Do they feel comfortable participating in sessions or working on homework tasks? And why?
Do the work: Understanding the cultures of the families and communities with which we work is a part of our job. Researching, asking questions, being patient, having exploratory conversations, and seeking advice from different communities when making resources are integral parts of working within CLD populations. Do the work; its our responsibility.
Being culturally competent and responsive isn’t something we implement overnight and tick off a list. It’s an ongoing and dynamic process; a conversation that starts with oneself.
Written by Kate Morling
Kate is the CEO and Senior Speech Pathologist at Communicate with Kate Speech Therapy. Kate has 10 years experience working across the globe with children with communication and learning differences as well as supporting early career speech pathologists.