Children's Administration, Department of Social and Health Services
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Indian Child Welfare Manual

CULTURAL ISSUES AND RESPONSES: DEFINING CULTURAL COMPETENCE IN CHILD WELFARE

Terry L. Cross, ACSW*

May 5, 1989

OVERVIEW

HISTORICAL PERSPECTIVE

The use of child welfare services for the protection of children is a relatively new development in the history of the world, especially for children of color. However, support and protection for children is as old as culture itself. Cultures around the world have historically had natural helping systems designed to ensure their future. Culturally-proscribed ways to nurture and protect children have included beliefs and practices which contributed to the development of strong families. Parenting, for example, was based on values and teachings that preserved the integrity of the society. Community norms, mores, and values guided families with regard to their child rearing and those who did not comply were often chastised or ridiculed into compliance. In many cultures the interdependence of the extended family provided an environment in which a child was served by a nurturing network of adults. A system of care existed which nurtured the whole child – physically, spiritually, and emotionally.

*A summary of remarks presented at the Child Welfare League of America’s Colloquium to Promote Culturally Responsive Child Welfare Practice, March 12–13, 1989, Washington D. C. Portions of this paper have previously been published in Focal Point , the newsletter of the Research and Training Center for Improved Services to Severely Emotionally Handicapped Children and their Families, Regional Research Institute, Portland State University School of Social Work and in Toward a Culturally Competent System of Care (1989), a monograph published by CASSP Technical Assistance Center, Georgetown University Child Development Center, Washington D. C. Reprinted by permission of the author, Director of the National Indian Child Welfare Association, Inc., Portland, OR.

Extended family systems insured that no one was overburdened with the care of a difficult child. In some cultures, beliefs that such children had special gifts ensured that they received proper care. Through dream interpretation, herbal remedies, purification customs and other ways various peoples were able to prevent serious problems before they occurred. In addition, culture helped identify roles for children as well as adults and regulated behavior and provided rules for interaction. By employing these and other practices each culture maintained an informal system of child welfare services. Today, various cultures still have informal systems. These informal systems exist alongside the formal system.

While natural systems at one time served the members of each respective culture, changes in the world made it difficult for those systems to withstand the influence of European domination. The impact of genocide, colonization, slavery, forced assimilation, and discrimination was to deprive some peoples of their traditional networks and to fragment and weaken others. Miraculously, many cultures have survived this phase of world history with their natural capacity to promote positive parenting at least somewhat intact. However, the nature of these natural systems have been seldom understood or valued by the formal system in existence today.

The welfare of minority children was largely ignored by the formal system of the dominant society until the middle of the century. It was not until recently that children of color were even considered by the dominant society asteachable,as we now think of that term. People of color have historically been seen as uncivilized and inferior and excluded from social services. In 1927, the California Conference of Social Work supported the denial of social services to Mexican Americans (Morales 1976 as cited in Lum 1986 p. 15). In 1911, the National Urban League was formed by Blacks in response to the unavailability of services to people of color. In the 1920’s, the helping professions turned their attention to intra-psychic processes.Blacks were rarely perceived as amenable to such treatment since there were so many other survival issues that took precedence(Lum 1986). As late as the 1950’sthe failure of ethnic minorities of color to assimilate was perceived as resulting from their own failing(Dieppa, 1983 p. 116 as cited in Lum 1986). In the 1960’s theories about minority cultures changed and the cultural deprivation idea was introduced. While this notion was liberal in intent, it completely ignored the richness of minority cultures.

The civil rights movement, subsequent legislation and a changing social consciousness opened the doors of many services and institutions previously closed to minorities. Many more people of color gained access to services and the education of minority professionals increased and peaked in the 1970’s. However, despite improved access to services the existing formal systems continued to fail to adequately serve children of color.

In a review of available data Stheno (1982) related a variety of troubling findings. Five patterns are reported by Stheno: higher rates of out-of-home placement among minority children than among white children; different, more restrictive patters of referral and diagnosis for

Black youths than for white youth; disproportionate numbers of Black children in less desirable placements; greater proportions of Black children served in the public sector than in the private sector; and less social services support received by minority parents than by non-minority parents.

The data is clear: the system of care continues differential treatment of minority children in various services systems.

Why? What portion of these issues are simply system of care issues that all children face and what portion is due to minority status? What can we do as corrective measures? Who can best respond to these needs? These and other questions have been a matter of serious debate in recent years as child welfare professionals have struggled with how to make the system more responsive to the needs of minority children and their families. Neither the questions nor the solutions are simple and while advocates from minority communities clamor for culturally-responsive services the professional world has had very little notion of what that means. The formal system continues to fail to recognize or value the strengths of minority cultures and the informal mechanisms extant within them which establish and maintain the welfare of children.

The child welfare system is beginning to address the issue of minority children from a new perspective: a perspective which emphasizes the cultural strengths of inherent in all cultures and examines how the system of care can more effectively deal with cultural differences and related service issues. This paper explores the model we callcultural competenceas a response to these issues.

If there is a real progress in this area then we must begin to define what culturally competent services look like. When we refer to culturally competent services we are referring to systems, agencies and practitioners who have the capacity to respond to the unique needs of populations whose cultures are different than that which might be called dominant or mainstream American. We have used the word culture because it implies the integrated pattern of human behavior that includes thought, communication, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group. We have used the word competence because it implies having the capacity to function in a particular way. In this case, the capacity to function capably within the context of culture. While this paper focuses on ethnic minorities of color it should be clear that the terminology and the thinking behind this model applies to everyone – everyone has, or is, part of a culture.

From a system level to agencies to the practitioner we must begin to clearly say what it is that we would be doing if, in fact, we were meeting the needs of minority children who are in need of child welfare services.

PROBLEMS AND ISSUES

The purpose of this section is to present a brief review of some of the issues and problems which affect the provision of child welfare services to minority group children. Minority people today face a variety of social, health and mental health problems. Since these problems and issues have received extensive treatment elsewhere in the literature what appears here is a synopsis.

Policy

Numerous policy issues affect service delivery to children who of minority cultures. First and foremost is the lack of a minority focus. Most states have not had a specific focus in this area. Many do not even count the number of minority children who receive services nor have they until they recently considered it important to do so. Few states include minority representation on policymaking boards and commissions and few minorities have been in key policymaking positions in management. Few states have addressed the issue of differential service delivery. While it has been clear for some time that minority children experience a

different point of entry into the system, few, if any, policies have addressed the issue. Policymakers have not known what to do nor have they had the resources to experiment with demonstration projects. The pervasive rate of out of home placement for minority children in non-minority homes continues to be a problem. Despite the Indian Child Welfare Act Indian children continue to be placed in out of home care at high rates. Trans-racial placement has become a major mental health issue for minority children who suffer from difficulties with identity formation, inadequate coping skills and loss of support systems.

Some states and counties are increasingly reliant on contracted services to children. Minority children have consistently been under-represented in private agencies with services designed to meet the needs of the dominant society. Little has been done in the area of contracting to assure that the private sector equip itself to effectively serve the minority child. Likewise, minority providers have too infrequently been identified, supported, or funded to serve their own children.

In some areas of the country minority governed and operated programs have developed. A debate has risen over whether separate services should be encouraged or whether existing mainstream agencies should become more accessible to minority clients. In reality, both approaches are essential to the continued improvement of services to minority children. The minority agency tends to add to the knowledge base for minority practice and is often able to provide services more cost effectively than mainstream agencies. However, in most areas minority children will inevitably be served in the mainstream agency. This factor is especially important when one considers the shift in population predicted by the year 2000 when nearly one-half of the client population will be minority. In addition, the focus today on the development of minority professionals is inadequate to meet the needs of the future.

Training

The training of minority child welfare professionals has been problematic in two ways. There is a shortage of trained minority persons to work in the field and the existing curricula for service providers inadequately address the needs of the minority community. The latter deficit is, in part, related to the lack of knowledge base in working cross-culturally. Until about ten years ago, there was little relevant literature to guide practice and even less in the policy area. While the literature has expanded greatly in the past decade it has not been widely

disseminated nor embraced by the mental health educators. Cross-cultural practice has not been institutionalized in most professional schools to the extend necessary. Where progress has been made, content has focused on the development of cultural knowledge about specific groups rather than on understanding culture and its function in human behavior. The field lacks standards to guide education in this area, because it has yet to define what one should know to be competent in serving minority clients.

Lack of a knowledge base has also troubled the pursuit of developing minority professionals. Schools training child welfare professionals have failed to consult the minority community about needed curricula and have failed to create learning environments congruent with minority learning needs. Also, the educational system for child welfare providers has too often focused on upper level degrees and not developed a continuum of service providers ranging from para professional to professional. When minority persons have successfully completed training they sometimes find that the education offered by the non-minority institution serves to alienate them from their community rather than make them a resource. Formal education all too often further assimilates the professional into the dominant society value system separating them from the very resources which are the greatest assets of their community. The minority professional soon learns that to become a credentialed professional can make one suspect in the eye of your own people. This is further complicated by the fact that educational opportunities are seldom within ones own community. Lack of appropriate content, restricted access, culturally unresponsive learning environments, and lack of community input into the process keeps the number of minority service providers at a minimum.

Resources

A number of resource issues affect service delivery to minority children. The greatest of these is accessibility. Child welfare services for minority children are inaccessible in a variety of ways. Minority communities may be isolated geographically from services, or access may be restricted by language, distrust, or cultural differences. For instance, it is difficult for the members of some groups to seek services when their perception may be that the child welfare system is an extension of the hostile state interested in scrutinizing the client rather than in helping them. Some minority persons avoid services where they do not see

people that look like themselves or people who respect them. They have come to expect the non-minority worker to be unable to relate to their needs and in some cases to even be a threat to their families. Whether access is restricted by physical barriers or emotional/cultural one, minority children do have access to the same level of services enjoyed by the rest of society.

Minority operated and controlled programs have developed to deal with this lack of access issue. However, their struggle for survival has been intense. Such agencies acutely feel the need for more trained minority professionals. These programs are often started as demonstrations and then find it difficult to get core operating support. They are seldom the beneficiaries of the private sector in the same way that mainstream established non-minority agencies are and continually struggle for survival. With scarce resources it is difficult for such programs to develop culturally-specialized approaches or materials for use with their clients. Often, innovative practice and administrative approaches go undisseminated and unreplicated.

Both minority and non-minority agencies lack such resources as culturally-specific parent training curricula, community education tools, prevention videos, etc. Although some of this type of material has been developed, better dissemination efforts are essential. Further, both types of agencies most often lack the technology which would help them tap into the vast resources of the informal helping networks of the family, community, church, or natural helper. There exists a need for the development of new practice theory and approaches for minority communities.

Practice

Practice issues that impact service delivery to minority children are varied and complex. Minority practice theory and practice approaches have been developing over the last several years but there is vast room for improvement. Some of the practice issues are cross-cultural issues, others are applicable regardless of who the service provider is. Cross-cultural issues include such things as historic distrust. Historic distrust is a dynamic which can occur between a helper of the dominant society and a client of a minority community. Part of what they bring to the helping relationship is the history of the relationship between their peoples. Usually, the client is much more acutely aware of this than the helper. Helpers are usually culturally unaware of or do not know how to

work through this issue and interpret it as resistance. Another issue involves language and communication behaviors. Each culture has customary patterns for speech, turns at talk, and etiquette for how conversations proceed. Most helpers are unfamiliar with the patterns of their clients’ culture, and thus, are not able to communicate effectively. Standard assessment techniques such as interviews and testing are culturally biased. Interviewers often fail to consider client adjustments to culturally different environments and misinterpret behavior. For example, minority individuals are viewed negatively when they do not exhibit the traits that the American mainstream value, i.e., punctuality, work, achievement, independence, etc.

Another factor which influences practice is the maintenance of stereotypic images of minority people by the dominant society. Unfortunately the media, textbooks and pop culture have conditioned most people to have negative impressions of minority individuals and cultures. Many helpers have unrealistic fears of their minority clients and stereotypic ideas of their lives. Even when mental health professionals learn more about a culture there is a tendency to simply replace old stereotypes with new ones and assume that all Indians do thus and Black families relate so. Most practitioners have not had the opportunity to learn the dynamics that are inherent in working cross-culturally and thus fail to establish rapport with their minority clients.

Both individual professionals and entire agencies are at various levels of capacity to deal with the issues discussed here. Many have mad progress and are providing responsive services. Others are just beginning to look at the problems. Following is a framework which is intended to help agencies begin a process of self-assessment and development.

CULTURAL COMPETENCE CONTINUUM

Cultural competence is a set of congruent behaviors, attitudes and policies that come together in a system, agency or professional and enable that system, agency or professional to work effectively in cross-cultural situations. Again, the word culture is used because it implies the integrated pattern of human behavior that includes thought, communication, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group. The word competence is used

because it implies having the capacity to function effectively. A culturally-competent system of care acknowledges and incorporates – at all levels – the importance of culture, the assessment of cross-cultural relations, vigilance towards the dynamics that result from cultural differences, the expansion of cultural knowledge and the adaptation of services to meet culturally unique needs.

Certainly this description of cultural competence seems idealistic. How can a system accomplish all of these things? How can it achieve this set of behaviors, attitudes and policies? Cultural competence may be viewed as a goal towards which agencies can strive. Accordingly, becoming culturally competent is a developmental process. No matter how proficient an agency may become, there will always be room for growth. It is a process in which the system of care can measure its progress according to the agency’s achievement of specific developmental tasks. As the tasks are defined the system will be guided toward progressively more culturally competent services. First, it is important for an agency to internally assess its level of cultural competence.

To better understand where one is in the process of becoming more culturally competent, it is useful to think of the possible ways of responding to cultural differences. Imagine a continuum which ranges from cultural proficiency to cultural destructiveness. There are a variety of possibilities between these two extremes. Here we describe six points along the continuum and the characteristics that might be exhibited at each position.

Cultural Destructiveness. The most negative end of the continuum is represented by attitudes, policies and practices which are destructive to cultures and consequently to the individuals within the culture. The most extreme example of this orientation is programs which actively participate in cultural genocide – the purposeful destruction of a culture. An example of cultural genocide is the systematic attempted destruction of Native American culture by the very services set up tohelp Indians, i.e., boarding schools. Equally destructive is the process of dehumanizing or sub-humanizing minority clients. Historically, some agencies have been actively involved in services that have denied people of color access to their natural helpers or healers, removed children of color from their families on the basis of race or purposely risked the wellbeing of minority individuals in social or medical experiments without their knowledge or consent. While we currently do not see many examples of this extreme in the mental health system, it provides us with

a reference point for understanding the various possible responses to minority communities. A system which adheres to this extreme assumes that one race is superior and should eradicatelessercultures because of their perceived subhuman position. Bigotry, coupled with vast power differentials, allows the dominant group to disenfranchise, control, exploit or systematically destroy the minority population.

Cultural Incapacity. The next position on the continuum is one at which the system or agencies do not intentionally seek to be culturally destructive but rather lack the capacity to help minority clients or communities. The system remains extremely biased, believes in the racial superiority of the dominant group and assumes a paternal posture towardslesserraces. These agencies may disproportionately apply resources, discriminate against people of color on the basis of whether theyknow their placeand believe in the supremacy of dominant culture helpers. Such agencies may support segregation as a desirable policy. They may act as agents of oppression by enforcing racist policies and maintaining stereotypes. Such agencies are often characterized by ignorance and an unrealistic fear of people of color. The characteristics of cultural incapacity include: discriminatory hiring practices, subtle messages to people of color that they are not valued or welcome, and generally lower expectations of minority clients.

Cultural Blindness. At the midpoint on the continuum the system and the agencies provide services with the express philosophy of being unbiased. They function with the belief that color or culture make no difference and that we are all the same. Culturally blind agencies are characterized by the belief that helping approaches traditionally used by the dominant culture are universally applicable; if the system worked as it should, all people – regardless of race or culture – would be served with equal effectiveness. This view reflects a well intended liberal philosophy; however, the consequences of such a belief are to make services so ethnocentric as to render them virtually useless to all but the most assimilated people of color.

Such services ignore cultural strengths, encourage assimilation and blame the victim for their problems. Members of minority communities are viewed from the cultural deprivation model which asserts that problems are the result of inadequate cultural resources. Outcome is usually measured by how closely the client approximates a middle class non-minority existence. Institutional racism restricts minority access to professional training, staff positions and services.

Eligibility for services is often ethnocentric. For example, foster care licensing standards in many states restrict licensure of extended family systems occupying one home. These agencies may participate in special projects with minority populations when monies are specifically available or with the intent ofrescuingpeople of color. Unfortunately, such minority projects are often conducted without community guidance and are the first casualties when funds run short. Culturally blind agencies suffer from a deficit of information and often lack the avenues through which they can obtain needed information. While these agencies often view themselves as unbiased and responsive to minority needs, their ethnocentrism is reflected in attitude, policy, and practice.

Cultural Pre-Competence. As agencies move toward the positive end of the scale they reach a position we will call cultural pre-competence. We have chosen this term because it implies movement. The pre-competent agency realizes its weaknesses in serving minorities and attempts to improve some aspect of their services to a specific population. Such agencies try experiments, hire minority staff, explore how to reach people of color in their service area, initiate training for their workers in cultural sensitivity, enter into needs assessments concerning minority communities, and recruit minority individuals for their boards of directors or advisory committees. Pre-competent agencies are characterized by the desire to deliver quality services and a commitment to civil rights. They respond to minority communities’ cry for improved services by asking,What can we do?One danger at this level is a false sense of accomplishment or of failure that prevents the agency from moving forward along the continuum. An agency may believe that the accomplishment of one goal or activity fulfills their obligation to minority communities or may undertake an activity that fails and are, therefore, reluctant to try again.

Another danger is tokenism. Agencies sometimes hire one or more (usually assimilated) minority workers and feel that they are then equipped to meet the need. While hiring minority staff is very important it is no guarantee that services, access or sensitivity will be improved. Because minority professionals are trained in the dominant society’s frame of reference they may be little more competent in cross-cultural practice than their co-workers. Minority professionals, like all professionals, need training on the function of culture and its impact on client populations. The pre-competent agency, however, has begun the process of becoming culturally competent and often only lacks information on what is possible and how to proceed.

Basic Cultural Competence. Culturally competent agencies are characterized by acceptance and respect for difference, continuing self-assessment regarding culture, careful attention to the dynamics of difference, continuous expansion of cultural knowledge and resources, and a variety of adaptations to service models in order to better meet the needs of minority populations. The culturally competent agency works to hire unbiased employees, seeks advice and consultation from the minority community and actively decides what it is and is not capable of providing to minority clients.

Advanced Cultural Competence. The most positive end of the scale is advanced cultural competence or proficiency. This point on the continuum is characterized by holding culture in high esteem. The culturally proficient agency seeks to add to the knowledge base of culturally competent practice by conducting research, developing new therapeutic approaches based on culture and publishing and disseminating the results of demonstration projects. The culturally proficient agency hires staff who are specialists in culturally competent practice. Such an agency advocates for cultural competence throughout the system and improved relations between cultures throughout society.

In conclusion, the degree of cultural competence an agency achieves is not dependent on any one factor. Attitudes, policies, and practice are three major areas where development can and must occur if an agency is to move toward cultural competence. Attitudes change to become less ethnocentric and biased. Policies change to become more flexible and culturally impartial. Practices become more congruent with the culture of the client from initial contact through termination. Positive movement along the continuum results from an aggregate of factors at various levels of an agency’s structure. Every level of the agency (board members, policymakers, administrators, practitioners and consumers) can and must participate in the process. At each level the principles of valuing difference, self-assessment, understanding dynamics, building cultural knowledge and adapting practice can be applied. As each level makes progress in implementing the principles and as attitudes, policies and practices change, the agency becomes more culturally competent.

THE CULTURALLY COMPETENT SYSTEM OF CARE

The culturally competent system of care is made up of culturally competent institutions, agencies and professionals. We have identified five essential elements which contribute to a system, institution or agency being able to become more culturally competent. The culturally competent system would: value diversity, be capable of cultural self-assessment, be conscious of the dynamics inherent when cultures intersect, have institutionalized cultural knowledge, and have developed adaptations to diversity. Further, each of these five elements must function at every level of the system. Attitude, policies and practices must all be congruent within all levels of the system. Practice must be based on accurate perceptions of behavior, policies must be impartial, and attitudes should be unbiased. As mentioned earlier unbiased does not mean color blind. It means recognition and acceptance of the difference of another with respect and valuing. Following is a further examination of the elements mentioned above.

VALUING DIVERSITY

To value diversity is to see and respect its worth. A system of care is strengthened when it is aware and accepts that the people it serves are from very different backgrounds and will make different choices based on culture. While all people share common basic needs, there are vast differences in how people of various cultures go about meeting or prioritizing those needs. These differences are as important as the similarities. Acceptance that each culture finds some behaviors, interactions, or values more important or desirable than others can help the system of care interact more successfully with differing cultures. In the system of care, awareness and acceptance of differences in communication, life view, and definition of health and family, are critical to the successful delivery of services.

CULTURAL SELF ASSESSMENT

The system of care must be able to assess itself and have a sense of its own culture and its relationship to other cultures. When planners and administrators of the system understand how that system is shaped by its culture, then it is easier for them to assess how the system interfaces with other cultures. System leaders can then choose courses

of action which minimize cross-cultural barriers. For example, if in the language of the systemfamilyrefers to nuclear family and in another culturefamilymeans extended family, then concepts such as family involvement will require some adjustment or they simply will not work. Only by better knowing the culture of the existing system of care can the complexities of cross-cultural interfacing be better understood.

DYNAMICS OF DIFFERENCE

What occurs in cross-cultural system interactions might be called thedynamics of difference.When a system of one culture interacts with a population from another, both may misjudge the other’s actions based on learned expectations. Both bring to the relationship unique histories with the other group and the influence of current political relationships between the two groups. Both will bring culturally prescribed patterns of communication, etiquette, and problem solving. Both may bring stereotypes with them or underlying feelings about serving or being served by someone who isdifferent.The minority population may exhibit behaviors which are uncomfortable to the system expressing tension and frustration. It is important to remember that this is creative energy engendered by the tension which is a natural part of cross-cultural relations especially when one of the cultures is in a politically dominant position. The system of care must be constantly vigilant for the dynamics of misinterpretation and misjudgment.

Without an understanding of cross-cultural dynamics, misinterpretation and misjudgment are likely to occur. It is important to note that this misunderstanding is a two way process. Thus, the labeldynamics of difference.These dynamics give cross-cultural relations a unique character that strongly influences the effectiveness of the system. By incorporating an understanding of these dynamics and their origins into the system the chances for productive cross-cultural interventions are enhanced.

INSTITUTIONALIZATION OF CULTURAL KNOWLEDGE

The system of care must sanction and, in some cases, mandate the incorporation of cultural knowledge into the service delivery framework. Every level of the system needs accurate information and continuous access to it. The practitioner must be able to know the client’s concept

of health, family and be able to effectively communicate. The supervisor must know how to provide cross-cultural supervision. The administrator must be able to know the character of the population the agency serves and how to make the services accessible. The board member or bureau head must be able to form links with minority community leaders so as not to plan ill-fated interventions. The system must develop mechanisms to secure knowledge when it does not readily possess it. It must make the development of knowledge possible through research demonstration and dissemination. It must facilitate network building and open lines of communication, while at the same time adapting its structure and process to better respond to the needs of all children.

ADAPTATION TO DIVERSITY

Each element described here builds a context for a cross-culturally competent system of care. The system can adapt or adjust its approach to help create a better fit between the needs of the minority group and the services available. Styles of management, definitions of who is included in thefamily,and service goals are but a few things that can be changed to meet cultural needs. Agencies, understanding the impact of oppression on mental health, can develop empowering interventions. For example, minority children repeatedly receive negative messages from the media about their cultural group. Programs can be developed that incorporate alternative culturally enriching experiences and that teach the origins of stereotypes and prejudices. By creating such efforts the system can begin to institutionalize cultural interventions as a legitimate helping approach. Only as professionals examine their practice and articulate effective helping approaches will practice improve. Each agency which engages in these efforts will add to the knowledge base.

Becoming culturally competent is a developmental process for the individual and for the system. It is not something that happens because we read a book or attend a workshop or even because we happen to be a minority person. It is a process born of commitment to provide quality services to all and a willingness to risk.

CONCLUSION

In conclusion, it is becoming increasingly clear that in order for the Child Welfare League of America to be successful in reaching its goal of cultural responsiveness, careful attention must be paid to the needs of minority children. CWLA must help member agencies plan, design, and implement services that are appropriate, accessible, and delivered in aculturally competent manner.

The CWLA Colloquium on Cultural Responsiveness is a beginning step in laying the groundwork for meeting the challenge of effectively serving minority children.

Improving services to children of color becomes even more imperative when the rapidly changing demographic makeup of the nation is considered. It is project that, by the year 2000, those now called minorities will outnumber what is now the majority in some states. Should such trends continue, the challenges that face the nation in planning and producing a system of care for children will change rapidly as well. The opportunity currently exists to plan and adapt in a thoughtful, culturally sensitive way a culturally competent system of care which could greatly impact the improvement of services to minority children, youth, and their families.

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