Rethinking Self-Awareness in Cultural Competence: Toward a Dialogic Self in Cross-Cultural Social Work

Yan, Miu Chung

ABSTRACT

The cultural competence approach has grown significantly in the North American human service professions. The reliance of social workers on cultural awareness to block the influence of their own culture in the helping process entails three problematic and conflicting assumptions, namely, the notion of human being as cultural artifact, the use of self as a technique for transcending cultural bias, and the subject-object dichotomy as a defining structure of the worker-client relationship. The authors contend that there are conceptual incoherencies within the cultural competence model's standard notion of self-awareness. The conceptualization of a dialogic self may unsettle the hierarchical worker-client relationship and de-essentialize the concept of culture. Cross-cultural social work thus becomes a site where client and worker negotiate and communicate to cocreate new meanings and relationships.

With cultural diversity increasing in North America, cross-cultural practice has grown significantly in the social work profession. Discussion among social work educators, researchers, and practitioners about training, practice, and theory building in cross-cultural social work abounds in the present literature (Goldberg, 2000). Cross-cultural social work can be generally defined as any working relationship "in which two or more of the participants differ with respect to cultural background, values and lifestyle" (D. W. Sue et al., 1982, p.47). In this article, we examine the major approach in cross-cultural social work, namely, the cultural competence model, which has also received tremendous attention in other human service professions such as counseling, health, and mental health. Although this article purports to provide an alternative insight for the social work profession, the discussion may be useful to other human service professions, members of which often engage cross-culturally with clients.

We contend that the cultural competence model's taken-for-granted notion of cultural awareness, which is a form of self-awareness that focuses particularly on one's cultural background, is conceptually incoherent. Its faith in a social worker's capacity to activate a set of techniques in order to suspend their own cultural influences contradicts its postulation of the individual as a cultural being. This conception of social workers' self-awareness also produces a hierarchical subject-object dichotomy in the worker-client relationship, as it assumes that social workers are subjects capable of becoming neutral and impartial culture-free agents, while clients are objects who stay within the limits of their culture, to be regarded as such by social workers. Borrowing insights from the social constructivist perspective and Mikhail Bakhtin's (1895-1975) theorization of dialogue, this article proposes a conceptualization of a dialogic self in cross-cultural practice. The dialogic self is an ongoing and fluid cocreation through intersubjective dialogue with others. We contend that understanding the self as dialogic unsettles the hierarchical worker-client relationship, saturating much of the existing discussion about cultural competence. The concept of the dialogic self in cross-cultural social work also eschews essentializing culture, both the worker's and the client's, and rather sees culture as fluid and changing.

What Is Cultural Competence?

In recent years, the cultural competence model has appeared as a panacea for problems related to cross-cultural social work practice in multicultural environments (Asamoah, 1996; Lum, 1999; Tsang & George, 1998). For instance, cultural competence is used as a standard to prepare social work students (Ronnau, 1994), to assess multicultural social work students' capability of working cross-culturally (Manoleas, 1994), to develop special tools to enhance skills when working with minorities (Ho, 1991), and to build a developmental model of intercultural sensitivity for baccalaureate social work students (Krajewski, Brown, Ziefert, & Kaufman, 1996). Cultural competence is a new model for various modes of practice such as social group work (Chau, 1992) and family therapy (Anderson, 1992). It is also an aid for communicating with and understanding clients from different cultures such as indigenous people (Weaver, 1999), African American men (King, 1994), African American women (Freeman, 1994), and ethnic elderly people (Saldov, 1992). At a macrolevel, cultural competence is also important to social work administrators in terms of organizational issues (Matthews, 1996) and program planning such as child welfare and permanency planning (Pinderhughes, 1997; Williams, 1997). Recently, the National Association of Social Workers (NASW)1 officially adopted a set of standards of cultural competence in social work practice (NASW, 2001), which strongly suggests that to be culturally competent is a professional-ethical responsibility. As Asamoah (1996) noted, "[t]he question is no longer one of 'whether' to provide culturally competent services to clients, but rather 'how' can we do it best" (p. 1). Despite some scholars' argument that cultural competence is a myth (Dean, 2001), cultural competence has been presumed to be the foundation of effective cross-cultural social work.

How to accurately define cultural competence, however, remains problematic (Hansen, Arreloa-Rockwell, & Greene, 2000; Pope-Davis, Liu, Toporek, & Brittan-Powell, 2001; S. Sue, 1998). Despite its prevalence in social work practice, "the concept remains rather abstract, and operationalization is difficult" (Boyle & Springer, 2001, p. 57). Among the various scholars who propose the cultural competence model (e.g., Cross, Bazron, Dennis, & Issacs, 1989; Green, 1999; Lum, 1999; McPhatter, 1997; Pinderhughes, 1989), several common threads can be identified, based mainly on the position paper developed by D. W. Sue et al. (1982) for cross-cultural counseling competencies. These scholars highlight three major dimensions of cultural competence: (a) awareness of and sensitivity to workers' own values, biases, and power differences with their clients; (b) knowledge of the practice environment, the helping methods, and the client's culture; and (c) skills in verbal and nonverbal communication. Sodowsky, Taffe, Gutkin, and Wise (1994) inserted the counseling relationship-the impact of the counselor's attitudinal factors on the counselor-client interaction-as the fourth dimension of cross-cultural competence.

Adapting these four aspects of cultural competence for cross-cultural social work practice, Lum (1999) commented that,

[c]ultural competency includes acceptance of and respect for cultural differences, analysis of one's own cultural identity and biases, awareness of the dynamics of difference in ethnic clients, and recognition of the need for additional knowledge, research, and resources to work with clients, (p. 29)

In other words, cultural awareness, knowledge acquisition, skills development, and inductive learning are the four intertwining factors of a successful cross-cultural social work encounter (Lum, 1999).

Two key elements-knowledge and skill-indicate that cultural competence is to some extent conceived as a technical solution to the challenges of cross-cultural social work. The assumption is that both the worker's and the client's cultures can be learned through social work education as well as managed through cultural sensitivity, modification of social work skills, and adaptation of services. Once social workers gain awareness and master the needed knowledge and skills, they can adjust their practice to meet the needs of their clients (Zayas, Torres, Malcolm, & DesRosiers, 1996). Moreover, as Lum (1999) suggested, cultural competence can be assessed by a set of "behavioral outcomes that are observable and measurable and demonstrate effective multicultural practice" (p. 174).

Self-Awareness: A Central Component of Cultural Competence

Discussion about cultural competence also emphasizes the importance of social workers' awareness of their cultural identification. Most cross-cultural social work scholars argue that social workers, like their clients, are cultural artifacts. People from different cultures are culturally different. Social workers bring their own cultural biases, values, and beliefs to their working relationship with clients from different cultures (Green, 1999; Lum, 1999). The dynamic of cultural difference therefore needs to be assessed (Lum, 1999). Many studies have shown that workers' value systems affect their ways of treating their clients (Roman, Charles, & Karasu, 1978). Holland's (2000) findings further indicated that social workers perceive their clients rather subjectively and that they derive their causal explanations from various sources of information, including their own personal experiences, which are influenced by their own cultures. Lu, Lum, and Chen (2001) also found that clinician ethnocultural characteristics may lead to clinicians' differing achievement styles, which, they assert, may affect client-clinician interaction and the intervention process.

In order to overcome the ingrained effect of their culture and to respect their client's difference, culturally competent social workers should analyze and maintain a high level of self-awareness of their own cultural background (Cross et al., 1989; Dana, Berlin, & Gonwa, 1992; Dewees, 2001; Green, 1999; Ho, 1991; Matthews, 1996; McPhatter, 1997; Miley, O'Melia, & DuBois, 1998; Pinderhughes, 1997; Ridley, Mendoza, Kanitz, Angermeier, & Zenk, 1994; Sowers-Hoag & SandauBeckler, 1996; D. W. Sue et al., 1982; Weaver, 1999). As D. W. Sue and Sue (1990) suggested, an awareness of his or her own cultural values, biases, preconceived notions, and personal limitations is one of the basic characteristics of a culturally competent worker. Self-awareness thus becomes the foundation of an effective cross-cultural social work relationship (Green, 1999). Lum (2003) concluded that "[t]he road to cultural competence begins with an understanding of your own personal and professional cultural awareness" (p. 75). Dewees (2001) also asserted that in cross-cultural practice, "[p]robably, the most salient maxim for any human service worker is 'knowing thyself'" (p. 39). Boyle and Springer (2001) made the same observation and commented that cross-cultural social work discourse has devoted most of its attention to issues of awareness of one's own biases.

Hence, social workers are expected to be aware of their cultural identifications and to control their own personal cultural influences. As Lum (1999) proposed, self-awareness is a preintervention activity through which workers will examine their own culture and their perception of the clients' culture. Miley et al. (1998) shared Lum's perspective and suggested that "[r]eflective social workers inventory their personal values and resources as a way of preparing to work with clients" (p. 61). With this inventory, social workers are assumed to have the ability "to sort out differences among values and cultural dimensions [beginning] with an intensive review and articulation of their own personal values and cultural heritage" (Miley et al., 1998, p. 68). Self-awareness is also a postintervention activity because of the need for ongoing inductive learning from what we have done, as Lum (1999) suggested. In summary, it is widely accepted that it is important for social workers to know how the role of culture affects them in their practice, particularly when the worker's and the client's cultures are different (Dewees, 2001).

Despite the recognition of the need for workers' awareness of their own culture, the influence of the worker's culture on how the client's problem is defined and handled has received only limited attention. For instance, both Green (1999) and Lum (1999) suggested four principles of problem identification in cross-cultural social work: the client's definition and understanding of an experience as a problem, the client's semantic evaluation of a problem, indigenous strategies of problem intervention, and culturally based problem resolution. These four principles do not include any element that relates to the culture of social workers and how it affects them in assessing the client's problem and in formulating intervention goals. Instead, reference is made solely to the culture of clients.

Indeed, despite variations in the understanding of cultural difference, almost all cross-cultural social work approaches, including the cultural competence model, are mainly concerned with how social workers can break through the cultural barrier and effectively work with clients of different cultural backgrounds. Seemingly, through pre- and postintervention self-reflection, social workers are presumed to be able to manage the influence of their own cultural values and to sustain their professional objectivity when they engage in a professional relationship with clients from different cultures. This notion of professionalism suggests that the worker's cultural heritage can be contained and/or suspended by factors such as the use of the professional self, through which the social worker can maintain self-discipline (Imre, 1982). After all, as Hamilton (1954) has long contended, the whole purpose of being self-aware is for social workers to make full professional use of their personal self.

Appreciation of the client's cultural background is widely accepted as the major variable of an effective cross-cultural working relationship. Green (1999) argued that"[c]ultural competence means only that the worker has a systematically-learned and tested awareness of the prescribed and proscribed values and behaviors of a specific community, and an ability to carry out professional activities consistent with that awareness" (p. 87). The "specific community" is merely the client's cultural community, whereas the "professional activities" are believed to be objective and non-judgmental. Much literature and research is, therefore, dedicated to issues of how culture affects our clients' problems and ways of coping.

A review of the discussion of self-awareness in present cross-cultural social work literature shows that the concept is largely an uncontested construct. There is scant theoretical discussion of what makes self-awareness possible. Empirical research on how it can be achieved in practice is also missing. In summary, the self-awareness discourse inadequately explores the relationship between culture and social workers.

The Contradiction of Self-Awareness in the Cultural Competence Model

There are at least three problematic assumptions in the conception of self-awareness in the cultural competence model, namely, the notion of human being as cultural artifact, the use of self as a technique for transcending cultural bias, and subject-object dichotomy as an organizing structure of the worker-client relationship. On the one hand, existing discussion of the cultural competence model suggests that both social workers and clients are culturally determined. On the other hand, through the professional use of self, workers can control the influence of their culture on themselves during the intervention process. These two assumptions are closely tied to the assumption of a subject-object dichotomy in the Cartesian monological approach of modern social science (McCarthy, 1984). On closer examination, these assumptions not only appear problematic but also contradict each other.

First, the cultural competence model insists on the importance of culture, which is generally defined in an essentialist manner. For instance, as summarized in the NASWs (2001) Standard of Cultural Competence Practice, "Culture is often referred to as the totality of ways [italics added] being passed on from generation to generation." It assumes that culture is both a form of social control with an integrative function (Angell, Kurz, & Gottfried, 1997) and "a resource and a source of strength for people" (Compton & Galaway, 1999, p. 234). Through cultures, human groups structure their behaviors, their worldviews, their perspectives on the rhythms and patterns of life, and their concepts of the essential nature of the human condition. In summary, cultures guide our behavior (Devore & Schlesinger, 1999), however brief our encounters with others (Green, 1999). One way or another, the model indicates that culture exerts a strong influence on humans. In general, the implicit assumption of cross-cultural discussion is that humans are, by nature, objects of culture. If that is so and if humans are always trapped in a cage of culture, then how is it possible for social workers to break through this cage? How can social workers control cultural influences if cultural influences control them?

Second, interestingly enough, the prescription of use of self does not presuppose this strong view of cultural influence, and herein lies an important contradiction. Most cultural competence proponents recognize that both workers and clients are culture bearers; therefore, it is important for workers to be aware of their own cultural values. As professionals, workers assume that they are capable, through a skillful use of professional self via special techniques, to maintain neutrality while working with their clients (Freidson, 1986; Parsons, 1939). As Goldberg (2000) described, "The social worker, unlike the client, needs to bracket, that is put aside, some cultural characteristics and be aware that his/her preference for them represents a personal taste" (p. 15). Social workers, unlike their clients, are presumed to be able to be both inside and outside their cultural cage by manipulating their professional self, which can be separated from their personal self. The self of the social worker, as Imre (1982) suggested, "is very much involved in the process of helping others. One of the commonly accepted goals in learning social work is mastering the 'conscious use of self,' which requires self-discipline. Self-discipline necessitates knowledge of the self" (p. 93). The very notion of "use of self" in social work practice is based on the premise that social workers can know themselves thoroughly, which is a prerequisite to effective interpersonal helping (Kondrat, 1999).

In opposition to the strong view of cultural influence, the prescription of use of self suggests that social workers can control their culture, but social work clients cannot. Social workers are understood to be capable of active self-reflection, and to be ethically bound to professional objectivity, as a function of their use of professional self, a technique that is learned through professional training. However, the prescription of use of self relies on the presumption of a subject-object dichotomy that prescribes social work intervention as a one-way process. The contention is that social workers are culturally competent helpers who can bracket their subjective and culturally biased selves in order to work with their clients from different cultures. In turn, workers help their clients to help themselves and to resolve their problems in a manner appropriate to the client's culture. Since social workers, using the professional self, can activate the self-awareness mechanism to withhold their own cultural influence, this one-way process is presumably free of the social worker's cultural biases.

Considering these assumptions together, we see that the cultural competence model reveals the entrenchment of a subject-object dichotomy in the social work profession (Irving, 1999). Workers are presumed to have professional commitments, organizational control, and a level of autonomy that can transcend the limits of cultural influence, all of which enables them to help their clients in a way that culturally fits the clients' needs. On the other hand, the role of social work clients is vague; they are portrayed as passive cultural objects without the capability to react, adjust, or modify their cultural limits. The unidirectional social work process leaves no space for the possibility of equal involvement between two equal human beings. The exclusion of that possibility is one of the major deficiencies of the present cultural competence model.

These assumptions of the dominant cultural competence discourse are problematic. They mask the influence of the culturally ingrained role of workers in the problem identification and resolution process (Abramson, 1996; Lam, 1998; Yan, 1998). The cultural competence model assumes that social workers are active human subjects who, as experts with special knowledge, can understand and help, whereas their clients are passive objects that can be understood, classified, objectified, stigmatized, and finally helped. The deployment of this subject-object dichotomy has been criticized by a number of interpretivist social work scholars (Goldstein, 1986; Goldstein, Hubert, & Hubert, 1984; Leonard, 1997) who contend that the social work process is an engagement of two human subjects who bring their own cultural values into the interpretation process.

In summary, the relationship between culture and social worker has been either simplified or omitted from mainstream cross-cultural social work discussion. Conceptualizing social work as art, England (1986) contended that social work is a process of helping and coping, both of which are subject to how people perceive and interpret their problems and resources. Our human perceptions are bound by our worldview, which is formulated within our cultural context (Lichtman, 1990). The perceptions of both social workers and their clients, therefore, are not free from their own cultural background. The cultural background of social workers is complex. It includes our ethnic/racial inheritance, professional values, and organizational mandates, to name just a few. Since cross-cultural social work is always situated in a broader cultural context, the culturally embedded roles of social workers are externally defined in many ways in which social workers may not even be aware. Like many other professionals, social workers use socially formulated labels to define their clients and their experiences as social objects that can be objectively assessed and responded to (Hacking, 1999). Indeed, it has been argued that social workers can never be free of cultural influences (Mattison, 2000; Pilsecker, 1994), regardless of how hard we try to be aware of our cultural background.

Implications for Practice: Toward a Dialogic Self in Cross-Cultural Social Work

Saleebey (1994) contended that social work is a process of understanding in which client, social worker, and cultures intersect and generate the meaning of helping and being helped. A professionally accountable and ethical cross-cultural social work practice, therefore, needs to reexamine the relationship between culture and social workers' experience of self, and how this relationship interplays with the cross-cultural client-worker relationship. Kondrat (1999) suggested that there are at least three approaches to self-awareness in social work practice. Each approach reflects a specific epistemological position and conceptualization of self. The first approach is simple conscious awareness, through which the social worker is awakened to an experience. The focus of awareness is on the experience itself, rather than on the self who is experiencing. The second approach is reflective awareness of the self who is experiencing. In this process, the self's behavior, affect, and cognitive content become the objects of reflection. The possibility of an objective self-reflection is premised on the conceptual division between a subject-self (I) and an object-self (me). The subject-I reflects on the experience of the object-me through the use of external sources such as peers' and clients' feedback and reflective tools such as video and audiotapes. This kind of reflection, therefore, relies on "the objectification of experience by distancing the knower from that which is known" (Kondrat, 1999, p. 455). These two approaches to self-awareness dominate much of the discussion of self-awareness in the cultural competence model.

The third approach to self-awareness is reflexive awareness. Those who take this approach argue that our knowledge of our self is inevitably reflexive, that is, self-referential. Any assessment of the self that is based on self-awareness is made by the same self who is being assessed. Moreover, the self who is reflecting and the self who is being reflected on reside in the same social and historical space. Therefore, the reflexive position considers the distinction between a subject-I and an object-me to be ontologically meaningless. The reflexive approach posits that, rather than by creating distance, self-knowledge is attained by reducing the distance between the knower and the known. Valid self-knowledge is possible because of the "mutual belonging" of the knower and the known. We can know the self because we are on "more or less similar terms with the self" (Kondrat, 1999, p. 457); that is, we are not a stranger to our self. This "subjective" knowledge-"knowledge derived largely from the knowing-I" (Kondrat, 1999, p. 457)-is sine qua non for interpersonal communication and understanding, since such communication rests, in part, on "one's ability to use intuitive familiarity with his or her own experience (derived from one's socializing communities) as a way of understanding others" (p. Kondrat, 1999,458).

In the reflexive awareness approach, the self is conceptualized not as a private and isolated psychological entity, but as a configuration of many (other) "selves" who make up the person. As Karl Tomm (1993) suggested, "our sense of self is generated in relation to others" (p. 77). Charles Taylor (1989) also maintained that "one cannot be a self on one's own" (p. 36). Rather, self exists only in relation to others, those conversation partners who were essential to self-definition and crucial to one's self-understanding. Penn and Frankfurt (1994) further argued that "there can be no T without the Other,' no Other' without the 'I,' and it is language that makes this so" (p. 221). A person's reality is thus coconstructed by his or her subjective consciousness in interaction with the social environment and mediated through language and culture. Using this notion of a relational self mediated through language, workers are encouraged to consider how their experience of self is constituted in interaction with others, and how together with the clients new meanings are negotiated and created in each social work instance. In other words, the self is an ongoing, fluid construction linked to social context and in dialogue with other people's perceptions of who the self is.

Similarly, one's understanding of one's own culture is always developed through interaction with others (Wagner, 1981). As Bakhtin (1986) stated, "it is only in the eyes of another culture that foreign culture reveals itself fully and profoundly" (p. 7). Our understanding of ourselves is incomplete if we do not have the other to contextualize our personal experience. Self-reflexivity is a dialogic process; that is, the self and the other are coauthored through language in interpersonal conversation (Bakhtin, 1990). The self-reflection process therefore requires workers to engage in intersubjective and reciprocal communication with their clients, who are also assumed to have the capacity for self-reflection and change. Both worker and client are subjected to similar immediate contextual influences, but from different social positions and with different experiential and cultural perspectives. An intersubjective reflection is a dialogic process in which both worker and client interactively negotiate, understand, and reflect on their cultures with reference to their understanding of the problem presented by the client. "In the dialogue, new questions are raised; the other responds to us by revealing new aspects and new semantic depths" (Miehls & Moffatt, 2000, p. 345). Using Bakhtin's work, Miehls and Moffatt (2000) proposed constructing social work identity on the basis of the reflexive self. The goal of self-reflection in reflexive awareness is "to work on oneself so that one creates new strategic possibilities for relationships" (p. 343). Self-reflection becomes "a search for ways to interact with the other which opens the relationship for new possibilities of discourse" (p. 342). Tsang and George (1998) cautioned social workers against assuming uniform culture among members of the same cultural group and argued that it is important that the practitioner takes up the challenge of negotiating meanings with individual clients who might have various internalized cultures. As Weingarten (1991) suggested, it is in relationships where two subjects meet and where new meanings are coconstructed that new forms of relationship emerge.

According to the reflexive approach, social workers' self-awareness in cross-cultural practice, therefore, is not about bracketing their own cultural influences, but about creating a dialogic space in which workers allow the inclusion of the client's world into theirs. In the dialogue, worker and client may initially bring with them their cultural conditions and influences, but neither of them is totally defined and confined by their culture. When the worker permits herself or himself to really experience and understand the client, she or he may be altered in that understanding. As Carl Rogers (1961) reflected on his 33-year career, he came to a central learning: "I have found it of enormous value when I can permit myself to understand another person" (p. 18). He further wrote,

Very rarely do we permit ourselves to understand precisely what the meaning of his statement is to him. I believe because understanding is risky. If I let myself really understand another person, I might be changed by that understanding. And we all fear change, (p. 18)

Such a dialogic encounter between two persons of two cultures, as Bakhtin (1986) contended, does not mean a blending of selves. Rather, each retains his or her own uniqueness, but "they are mutually enriched" (p. 7). On the one hand, the worker learns from the client's experiences in ways that may make him or her a different person. On the other hand, the client may also find himself or herself changing when she or he experiences full understanding and acceptance from someone. Miehls and Moffatt (2000) argued that the social worker promotes healthy change when he or she can allow himself or herself "to be reconstituted in the presence of the other" (p. 346). Self-awareness, therefore, is not an isolated and individual process, but "one in which the social worker must be open to the influence of the other in the creation of enhanced practice" (p. 346).

Conclusion

In this article, we have examined the conceptual incoherencies abiding in the construct of self-awareness in the cultural competence model. We have argued that discussion of culture and social worker is inadequate in the existing literature on cultural competence. Reviewing the different approaches to self-awareness in social work practice and adapting Bakhtin's theorization of dialogue, we propose the conceptualization of a dialogic self for cross-cultural social work. The respective selves of the worker and client are not fixed and individual psychological and cultural entities, but rather are in an ongoing process of coconstruction. Our goal, therefore, is not about attaining "cultural competence." Nor is the task of self-awareness about putting aside and controlling one's cultural influences. Instead, self-awareness is a process of reflexive awareness in which social workers are cognizant of how their self may contribute to their perception and experience of their interaction with the client as well as the behavior of the client. Furthermore, reflexive awareness is a process in which social workers are enriched through being open to include the client's worldview into theirs as they seek to understand the client. Cross-cultural social work, like many other human services, thus becomes a site where client and worker from different cultures negotiate and communicate to cocreate new meanings and relationships.

1 Please refer to the NASW Web site at www.naswdc.org. Access to the electronic version of the Standards is limited to NASW members.

References

Abramson, M. (1996). Reflections on knowing oneself ethically: Towards a working framework for social work practice. Families in Society, 77, 195-201.

Anderson, J. D. (1992). Family centre practice in the 1990's: A multicultural perspective. Journal of Multicultural Social Work, 1, 17-29.

Angell, G. B., Kurz, B. J., & Gottfried, G. M. (1997). Suicide and North American Indians: A social constructivist perspective. Journal of Multicultural Social Work, 6, 1-26.

Asamoah, Y. (1996). Culturally sensitive service delivery: imperatives for the future, journal of Multicultural Social Work, 4(4), 1-6.

Bakhtin, M. (1986). Speech genres and other late essays (V. McGee, Trans.). Austin, TX: University of Texas Press.

Bakhtin, M. (1990). Author and hero in aesthetic activity. In Holquist, M. & Liapunov, V. Art and answerability: Early philosophical essays (pp. 4-256). Austin: University of Texas Press.

Boyle, D. P., & Springer, A. (2001). Toward a cultural competence measure for social work with specific populations. Journal of Ethnic & Cultural Diversity in Social Work, 9, 53-71.

Chau, K. L. (1992). Educating for effective group work practice in multicultural environments. Journal of Multicultural Social Work, 1, 15.

Compton, B. R., & Galaway, B. (1999). Social work process (6th ed.). Pacific Grove, CA: Brooks/Cole.

Cross, T. L., Bazron, B. J., Dennis, K. W., & Issacs, M. R. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed. Washington, DC: Georgetown University Child Development Center.

Dean, R. G. (2001). The myth of cross-cultural competence. Families in Society, 82, 623-630.

Devore, W., & Schlesinger, E. G. (1999). Ethnic-sensitive social work practice (5th ed.). Needham Heights, MA: Allyn & Bacon.

Dewees, M. (2001). Building cultural competence for work with diverse families: Strategies from the privileged side. Journal of Ethnic & Cultural Diversity in Social Work, 9, 33-51.

England, H. (1986). Social work as art (1st ed.). London: Alien & Unwin.

Freeman, E. M. (1994). African-American women and the concept of cultural competence. Journal of Multicultural Social Work, 3, 61-76.

Freidson, E. (1986). Professional powers: A study of the institutionalization of formal knowledge. Chicago: University of Chicago Press.

Goldberg, M. (2000). Conflicting principles in multicultural social work. Families in Society, 81, 12-21.

Goldstein, H. (1986). Toward the integration of theory and practice: A humanistic approach. Social Work, 31, 352-357.

Goldstein, H., Hubert, H., & Hubert, J. (Eds.). (1984). Creative change: A cognitive-humanistic approach to social work practice. New York: Tavistock.

Green, J. W. (1999). Cultural awareness in the human services: A multi-ethic approach (3rd ed.). Needham Heights, MA: Allyn & Bacon.

Hacking, I. (1999). The social construction of what? Cambridge, MA: Harvard University Press.

Hamilton, G. (1954). Self-awareness in professional education. Social Casework, 35, 371-379.

Hansen, N. D., Arreloa-Rockwell, F. P., & Greene, A. F. (2000). Multicultural competence: Criteria and case examples. Professional Psychology: Research and Practice, 31, 652-660.

Ho, M. K. (1991). Use of ethnic-sensitive inventory (ESI) to enhance practitioner skills with minorities. Journal of Multicultural Social Work, 1, 57-67.

Holland, S. (2000). The assessment relationship: Interactions between social workers and parents in child protection assessments. British Journal of Social Work, 149-161.

Imre, R. W. (1982). Knowing and caring: Philosophical issues in social work. Washington, DC: University of Press of America.

Irving, A. (1999). Waiting for Foucault: Social work and the multitudinous truth(s) of life. In A. S. Charmbon, A. Irving, & L. Epstein (Eds.), Reading Foucaultfor social work (pp. 27-50). New York: Columbia University Press.

King, A. E. O. (1994). An Afrocentric cultural awareness program for incarcerated African-American males. Journal of Multicultural Social Work, 3, 17-28.

Kondrat, M. E. (1999). Who is the "self" in self-aware: Professional self-awareness from a critical theory perspective. Social Service Review, 73(4), 451-477.

Krajewski, J. E. R., Brown, K. S., Ziefert, M., & Kaufman, E. (1996). Utilizing international clinical practice to build inter-cultural sensitivity in social work students. Journal of Multicultural Social Work, 4, 15-29.

Lam, C. M. (1998). Adolescent development in the context of Canadian Chinese immigrant families. Canadian Social Work Review, 15, 177-191.

Leonard, P. (1997). Postmodern welfare. London: Sage.

Lichtman, R. (1990). The production of human nature by means of human nature. Capitalism, Nature, Socialism, 4, 13-51.

Lu, Y. E., Lum, D., & Chen, S. (2001). Cultural competency and achieving styles in clinical social work: A conceptual and empirical exploration. Journal of Ethnic & Cultural Diversity in Social Work, 9, 1-32.

Lum, D. (1999). Culturally competent practice: A framework for growth and action. Pacific Grove, CA: Brooks/Cole.

Lum, D. (Ed.). (2003). Culturally competent practice: A framework for understanding diverse groups and justice issues. Toronto: Brooks/Cole.

Manoleas, P. (1994). An outcome approach to assessing the cultural competence of MSW students. Journal of Multicultural Social Work, 3, 43-57.

Matthews, L. (1996). Culturally competent models in human services organizations. Journal of Multicultural Social Work, 4, 131-135.

Mattison, M. (2000). Ethical decision making: The person in the process. Social Work, 45, 201-212.

McCarthy, T. (1984). Translator's introduction. In J. Habermas (Ed.), The theory of communicative action (Volume 1): Reason and the rationalization of society (pp. vii-xxxix). Boston: Beacon Press.

McPhatter, A. R. (1997). Cultural competence in child welfare: What is it? How do we achieve it? What happens without it? Child Welfare, 76(1), 255-278.

Miehls, D., & Moffatt, K. (2000). Constructing social work identity based on reflexive self. British Journal of Social Work, 30, 339-348.

Miley, K. K., O'Melia, M., & DuBois, B. L. (1998). Generalist social work practice: An empowering approach (2nd ed.). Needham Heights, MA: Allyn & Bacon.

Parsons, T. (1939). The profession and social structure. Social Force, 17, 457-467.

Penn, P., & Frankfurt, M. (1994). Creating a participant text: Writing, multiple voices, narrative multiplicity. Family Process, 33, 217-231.

Pilsecker, C. (1994). Essay: Starting where the client is. Families in Society, 75, 447-452.

Pinderhughes, E. (1989). Understanding Race, Ethnicity, and Power: The Key to Efficacy in Clinical Practice. New York: Free Press.

Pinderhughes, E. (1997). Developing diversity competence in child welfare and permanency planning. Journal of Multicultural Social Work, 5, 19-38.

Pope-Davis, D. B., Liu, W. M., Toporek, R. L., & Brittan-Powell, C. S. (2001). What's missing from multicultural competency research: Review, introspection, and recommendations. Cultural Diversity & Ethnic Minority Psychology, 7, 121-138.

Ridley, C. R., Mendoza, D. W., Kanitz, B. E., Angermeier, L., & Zenk, R. (1994). Cultural sensitivity in multicultural counseling: A perceptual schema model. Journal of Counseling Psychology, 41, 125-136.

Rogers, C. R. (1961). A therapist's view of psychotherapy: On becoming a person. London: Constable & Company.

Roman, M., Charles, E., & Karasu, T. B. (1978). The value system of psychotherapists and changing mores. Psychotherapy: Theory, Research, and Practice, 15, 409-415.

Ronnau, J. P. (1994). Teaching cultural competence: Practical ideas for social work educators. Journal of Multicultural Social Work, 3, 29-42.

Saldov, M. (1992). Communication needs of the ethnic elderly in hospitals and nursing homes. Journal of Multicultural Social Work, 2, 1-9.

Saleebey, D. (1994). Culture, theory, and narrative: The intersection of meaning in practice. Social Work, 39, 351-359.

Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Development of the multicultural counseling inventory: A self-report measure of multicultural competencies. Journal of Counseling Psychology, 41, 137-148.

Sowers-Hoag, K. M., & Sandau-Beckler, P. (1996). Educating for cultural competence in the generalist curriculum. Journal of Multicultural Social Work, 4, 37-56.

Sue, D. W., Bernier, J. E., Durran, L, Feinberg, L., Pedersen, P., Smith, E. J., & Vasquez-Nuttal, E. (1982). Position paper: Cross-cultural counseling competencies. The Counseling Psychologist, 10, 45-52.

Sue, D. W, & Sue, D. (1990). Barriers to effective cross-cultural counseling. New York: Wilev.

Sue, S. (1998). In search of cultural competence in psychotherapy and counseling. American Psychologist, 53, 440-448.

Taylor, C. (1989). Sources of the self. Cambridge, MA: Harvard University Press.

Tomm, K. (1993). A courage to protest: A commentary on Michael White's work. In S. Gilligan & R. Price (Eds.), Therapeutic conversations (pp. 62-80). New York: Norton.

Tsang, A. K. T., & Bogo, M. (1997). Engaging with clients cross-culturally: Towards developing research-based practice. Journal of Multicultural Social Work, 6, 73-91.

Tsang, A. K. T., & George, U. (1998). Towards an integrated framework for cross-cultural social work practice. Canadian Social Work Review, 15, 73-93.

Wagner, R. (1981). The invention of culture. Chicago and London: University of Chicago Press.

Weaver, H. N. (1999). Indigenous people and the social work profession: Defining culturally competent service. Social Work, 44, 217-225.

Weingarten, K. (1991). The discourses of intimacy: Adding a social constructionist and feminist view. Family Process, 30, 285-305.

Williams, C. W. (1997). Personal reflections on permanency planning and cultural competency. Journal of Multicultural Social Work, 5, 9-18.

Yan, M. C. (1998). Social functioning discourse in Chinese context: Developing social work in mainland China. International Social Work, 41, 181-194.

Zayas, L. H., Torres, L. R., Malcolm, J., 8; DesRosiers, F. S. (1996). Clinicians' definitions of ethnically sensitive therapy. Professional Psychology: Research and Practice, 27, 78-82.

Miu Chung Yan, PhD, is assistant professor, University of British Columbia, Canada, School of Social Work and Family Studies. Dr. Yan was previously the director of the Institute of Multicultural Research and Social Work Practice of San Francisco State University. Yuk-Lin Renita Wong, PhD, is associate professor, York University, Canada, School of Social Work. Correspondence regarding this article may be sent to the first author at miu.yan@ubc.ca or School of Social Work and Family Studies, University of British Columbia, 2080 West Mall, Vancouver, BC V6T 1Z2, Canada.

Manuscript received: February 20, 2004

Revised: June 15, 2004

Accepted: June 24, 2004

Copyright Families in Society Apr-Jun 2005
Provided by ProQuest Information and Learning Company. All rights Reserved