text
stringlengths 0
4.43k
|
|---|
When defining the ideas that surround cultural competence training, defining what culture is can help to understand the ideas that shape the concept. Culture is defined as the set of shared attitudes, values, goals, and practices that characterizes an institution or organization. When looking at culture in terms of cultural competence training, certain groups of individuals should be focused on because of their relevance to society. There are many groups that are marginalized and underrepresented; a few examples of concepts that make up one's cultural identity follow. The approach to identity helps to shape the ideas and themes that go into cultural competence training. |
LGBTQIA |
The initialism LGBTQIA stands for lesbian, gay, bisexual, transsexual, transgender, queer, intersex, and asexual. This particular group of individuals has faced numerous obstacles and has historical events to highlight the inequalities they face, such as the Stonewall riots. The Stonewall riots became a symbol for the gay liberation movement when police attempted a raid at the Stonewall Inn to arrest the gay and lesbian patrons and the gay community fought back. Numerous systemic oppressions historically and currently target LGBTQIA individuals. |
Race |
Race is a sensitive aspect of cultural competency training that requires professionals to be able to identify, acknowledge and value cultural differences. Training on this aspect of cultural competence teaches professionals that to ignore racial differences is a form of microaggression that can help exacerbate racial inequalities. In order to begin to understand intercultural communications, one must understand the historical and social context under which different cultural groups operate. For example, the history related to the cultural genocide of indigenous peoples in North America, understanding the said group's value system, their ways of learning, and logic is essential in being able to understand how certain aspects of their culture may be similar or different from our own. Such distinction must be approached with respect and without ascribing superiority or inferiority to the difference, that is, in a culturally sensitive fashion. |
Religion |
Religious differences can play a role in how professionals interact and communicate with others. Religiosity refers to the nature and extent of public and private religious activity, including belief in God, prayer, and place of worship attendance. Religiosity is usually linked to formal religious traditions (such as Christianity), institutions (such as mosques), sacred texts (such as The Book of Mormon), and a definitive moral code (such as the Decalogue). Spirituality can be an important part of religion but can also exist independent of extant faith traditions, involving a variety of more individual subjective beliefs and activities related to the sacred. In this aspect of cultural competence training professionals should learn how to have religious competence. Religious competence refers to skills, practices, and orientations that recognize, explore, and harness patient religiosity to facilitate diagnosis, recovery, and healing. Religious competence involves the learning and deployment of generic competencies, including active listening and a nonjudgmental stance. It is also an overarching orientation, providing a safe place for discussion of religious issues and identities received in a humble, respectful, and empathetic manner. |
Nationality |
In terms of nationality, particularly for people who are immigrants, the recent increase in global migration make them an increasingly common demographic everywhere. Though they will have varying cultures as well. It is important for those who are trained to understand both similarities and differences between themselves, and the individual they are helping. With this knowledge, it makes the process of aiding the individual more efficient and successful. Both the past nation the individual has come from, and their journey of immigration as an experience, can shape their mentality. To have specialists with specific nationalities help explain some differences is a helpful strategy. |
In school |
School is considered to be the second learning home for children. Every year a large number of people come to the United States. These groups of people are often families, including small children. In today's world, cultural competency plays a vital role in shaping the kids future. The United States is not the front runner in cultural competency training amongst children, with Canada and Australia apparently more progressive in this sector. Cultural competency training can be a huge help for the families who are thinking of adopting a foster child, specifically, if that child was born outside of United States. A school is a mixture of different races and cultures and as an educator, one must be sensitive to everyone's needs. Different cultures act uniquely to the different situations, and as an educator, one has to not only value diversity, but also have a strategy for everyone to feel welcomed. |
In the workforce |
Over the years, there have been new developed ways of practicing cultural competency in the workforce. There are many different methods that would allow assistance in cultural competency such as: global leadership programs, international team building exercises and specific cross-cultural skills training for special executive positions. Having a good grasp on the many different cultures that exist is increasingly becoming a major principle in the workforce. The techniques for cultural competency training must be practiced more than just in class room lecture. Trainers must be extremely educated in this matter to be able to sufficiently train people. They must take notice of their own biases perspective and about the different types cultures that receive discrimination. |
In healthcare |
In the medical setting, effective communication between clinicians, patients, families and other health care providers is fundamental.Health disparities refer to gaps in the quality of health and health care across racial, ethnic, and socioeconomic groups. Studies have demonstrated the multiple factors that contribute to health disparities.Cultural Competence Online for Medical Practice (CCOMP) is an attempt in the United States to address one of the factors - the patient-doctor interaction. The CCOMP project is funded by a grant from the National Institutes of Health (NIH) through the National Heart Lung and Blood Institute (NHLBI). CCOMP offers a clinician's guide to reduce cardiovascular disparities, intended to create effective cross-cultural approaches to care for African-American patients with cardiovascular disease, especially hypertension. Videos with real patient scenarios and case-based modules are aimed at developing this increased awareness. |
References |
Further AcknowledgementsCulturally Sensitive Intervention – Birmingham: a research project of Cooper Green Mercy Hospital and the University of Alabama at Birmingham, funded by Finding Answers: Disparities Research for Change. |
TRUST project, Alabama Collaboration for Cardiovascular Equality (ACCE), funded by NHLBI. |
Health BELIEF Attitudes Survey. |
External links |
National Consortium for Multicultural Education funded by the NHLBI |
Think Cultural Health by the Office of Minority Health |
National Center for Cultural Competence at Georgetown University |
Cross Cultural Health Care Program |
Program For Multicultural Health by the University of Michigan |
Building Cross-Cultural Partnerships in Public Health by the Alabama Department of Public Health (video) |
A Physician's Practical Guide to Culturally Competent Care by the Office of Minority Health |
Discrete trial training |
Discrete trial training (DTT) is a technique used by practitioners of applied behavior analysis (ABA) that was developed by Ivar Lovaas at the University of California, Los Angeles (UCLA). DTT uses direct instruction and reinforcers to create clear contingencies that shape new skills. Often employed as an early intensive behavioral intervention (EIBI) for up to 30–40 hours per week for children with autism, the technique relies on the use of prompts, modeling, and positive reinforcement strategies to facilitate the child's learning. It previously used aversives to punish unwanted behaviors. DTT has also been referred to as the "Lovaas/UCLA model", "rapid motor imitation antecedent", "listener responding", errorless learning", and "mass trials". |
Technique |
Discrete trial training (DTT) is a process whereby an activity is divided into smaller distinct sub-tasks and each of these is repeated continuously until a person is proficient. The trainer rewards successful completion and uses errorless correction procedures if there is unsuccessful completion by the subject to condition them into mastering the process. When proficiency is gained in each sub-task, they are re-combined into the whole activity: in this way proficiency at complex activities can be taught.: 93 DTT is carried out in a one-on-one therapist to student ratio at the table. Intervention can start when a child is as young as two years old and can last from two to six years. Progression through goals of the program are determined individually and are not determined by which year the client has been in the program. The first year seeks to reduce self-stimulating ("stimming") behavior, teach listener responding, eye contact, and fine and gross motor imitation, as well as to establish playing with toys in their intended manner, and integrate the family into the treatment protocol. The second year teaches early expressive language and abstract linguistic skills. The third year strives to include the individual's community in the treatment to optimize "mainstreaming" by focusing on peer interaction, basic socializing skills, emotional expression and variation, in addition to observational learning and pre-academic skills, such as reading, writing, and arithmetic. Rarely is the technique implemented for the first time with adults.DTT is typically performed five to seven days a week with each session lasting from five to eight hours, totaling an average of 30–40 hours per week. Sessions are divided into trials with intermittent breaks, and the therapist is positioned directly across the table from the student receiving treatment. Each trial is composed of the therapist giving an instruction (i.e., "Look at me", "Do this", "Point to", etc.), in reference to an object, color, simple imitative gesture, etc., which is followed by a prompt (verbal, gestural, physical, etc.). The concept is centered on shaping the child to respond correctly to the instructions throughout the trials. Should the child fail to respond to an instruction, the therapist uses either a "partial prompt" (a simple nudge or touch on the hand or arm) or a "full prompt" to facilitate the child to successfully complete the task. Correct responses are reinforced with a reward, and the prompts are discontinued as the child begins to master each skill.The intervention is often used in conjunction with the Picture Exchange Communication System (PECS) as it primes the child for an easy transition between treatment types. The PECS program serves as another common intervention technique used to conform individuals with autism. As many as 25% of autistic individuals have no functional speech. The program teaches spontaneous social communication through symbols or pictures by relying on ABA techniques. PECS operates on a similar premise to DTT in that it uses systematic chaining to teach the individual to pair the concept of expressive speech with an object. It is structured in a similar fashion to DTT, in that each session begins with a preferred reinforcer survey to ascertain what would most motivate the child and effectively facilitate learning. |
Effectiveness |
Limited research shows DTT to be effective in enhancing communication, academic and adaptive skills, as many studies are of low quality research design and there needs to be more larger sample sizes. |
Society and culture |
In media |
A 1965 article in Life magazine entitled Screams, Slaps and Love has a lasting impact on public attitudes towards Lovaas's therapy. Giving little thought to how their work might be portrayed, Lovaas and parent advocate Bernie Rimland, M.D., were surprised when the magazine article appeared, since it focussed on text and selected images showing the use of aversives, including a close up of a child being slapped. Even after the use of aversives had been largely discontinued, the article continued to have an effect, galvanizing public concerns about behavior modification techniques. |
United States cost |
In April 2002 treatment cost in the U.S. was about US$4,200 per month ($50,000 annually) per child. The 20–40 hours per week intensity of the program, often conducted at home, may place additional stress on already challenged families. |
Public opposition |
Organizations including the Autism National Committee (AutCom) have publicly stated their opposition to discrete trial training (DTT) and similar programs. |
History |
Discrete trial training is rooted in the hypothesis of Charles Ferster that autism was caused in part by a person's inability to react appropriately to "social reinforcers", such as praise or criticism. Lovaas's early work concentrated on showing that it was possible to strengthen autistic people's responses to these social reinforcers, but he found these improvements were not associated with any general improvement in overall behavior.In a 1987 paper, psychologists Frank Gresham and Donald MacMillan described a number of weaknesses in Lovass's research and judged that it would be better to call the evidence for his interventions "promising" rather than "compelling".Lovaas's original technique used aversives such as striking, shouting, and electrical shocks to punish undesired behaviors. By 1979, Lovaas had abandoned the use of aversives, and in 2012 the use of electric shocks was described as being inconsistent with contemporary practice. In 1985, Massachusetts medical authorities intervened after a case of fatal starvation at the Judge Rotenberg Center in which a 19-year-old woman was denied food by staff as a punishment.: 97 |
See also |
Professional practice of behavior analysis |
References |
External links |
Lovaas Institute for Early Intervention |
Fascia training |
Fascia training describes sports activities and movement exercises that attempt to improve the functional properties of the muscular connective tissues in the human body, such as tendons, ligaments, joint capsules and muscular envelopes. Also called fascia, these tissues take part in a body-wide tensional force transmission network and are responsive to training stimulation. |
Origin |
Whenever muscles and joints are moved this also exerts mechanical strain on related fascia. The general assumption in sports science had therefore been that muscle strength exercises as well as cardiovascular training would be sufficient for an optimal training of the associate fibrous connective tissues. However, recent ultrasound-based research revealed that the mechanical threshold for a training effect on tendinous tissues tends to be significantly higher than for muscle fibers. This insight happened roughly during the same time in which the field of fascia research attracted major attention by showing that fascial tissues are much more than passive transmitters of muscular tension (years 2007 – 2010). Both influences together triggered an increasing attention in sports science towards the question whether and how fascial tissues can be specifically stimulated with active exercises. |
Principles |
Subsets and Splits